Objective To systematically summarize the best evidence for the prevention of peripherally inserted central venous catheter(PICC)-associated infection,and provide evidence-based basis for healthcare workers to for-mulate management strategies for the prevention of PICC-associated infection.Methods According to the"6S"model of the evidence pyramid,relevant literatures on the prevention of PICC-related infection were systematically retrieved from top to bottom from UpToDate,websites of World Health Organization,Centers for Disease Control and Prevention,Infusion Nurses Society,Registered Nurses' Association of Ontario,New South Wales Agency for Clinical Innovation,National Health Commission of the People'Republic of China,Medlive,PubMed,Web of Sci-ence,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and SinoMed Database.The types of included literatures were clinical decision-making,guidelines,consensus,evidence summa-ries,and systematic reviews.The retrieval search window was from the establishment of the database to August 2024.Two researchers independently evaluated the quality of literatures and extracted evidence.Results A total of 19 papers were included in the analysis,including 2 clinical decisions,9 guidelines,6 expert consensuses,1 evi-dence summary,and 1 systematic review.Ultimately,28 pieces of evidence covering 6 topics including manage-ment,tools,catheterization,maintenance,infusion,and removal were formed.Conclusion This study summarizes the best evidence for preventing PICC-related infection,and recommends that clinical healthcare workers apply rele-vant evidence rationally and prudently,so as to reduce the incidence of PICC-related infections.

Objective To systematically summarize the best evidence for the prevention of peripherally inserted central venous catheter(PICC)-associated infection,and provide evidence-based basis for healthcare workers to for-mulate management strategies for the prevention of PICC-associated infection.Methods According to the"6S"model of the evidence pyramid,relevant literatures on the prevention of PICC-related infection were systematically retrieved from top to bottom from UpToDate,websites of World Health Organization,Centers for Disease Control and Prevention,Infusion Nurses Society,Registered Nurses' Association of Ontario,New South Wales Agency for Clinical Innovation,National Health Commission of the People'Republic of China,Medlive,PubMed,Web of Sci-ence,Cochrane Library,Embase,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and SinoMed Database.The types of included literatures were clinical decision-making,guidelines,consensus,evidence summa-ries,and systematic reviews.The retrieval search window was from the establishment of the database to August 2024.Two researchers independently evaluated the quality of literatures and extracted evidence.Results A total of 19 papers were included in the analysis,including 2 clinical decisions,9 guidelines,6 expert consensuses,1 evi-dence summary,and 1 systematic review.Ultimately,28 pieces of evidence covering 6 topics including manage-ment,tools,catheterization,maintenance,infusion,and removal were formed.Conclusion This study summarizes the best evidence for preventing PICC-related infection,and recommends that clinical healthcare workers apply rele-vant evidence rationally and prudently,so as to reduce the incidence of PICC-related infections.

Objective    To explore the safety and feasibility of uni-portal video-assisted thoracic surgery (VATS) for the treatment of bronchopulmonary sequestration (BPS). Methods    The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed. The patients were divided into a VATS group and a thoracotomy group according to the operation method. The operation time, intraoperative blood loss, hospital stay and postoperative complication rate were compared between the two groups. The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis. Results    Finally 131 patients were enrolled, including 62 males and 69 females with an average age of 39.3±13.2 years. There were 103 patients in the VATS group and 28 patients in the thoracotomy group. A total of 104 patients were diagnosed with left lower BPS, 26 with right lower BPS and 1 with bilateral lower BPS. The main symptom was cough (88 patients, 67.2%). There were 119 patients diagnosed by thoracic enhanced CT before operation. Compared with the thoracotomy group, the operation time was not statistically different (P=0.717), but the blood loss was less, the rate of postoperative complication was lower and hospital stay was shorter in the VATS group (P<0.05). The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8% and 13.5%, respectively. Meanwhile, patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay, less blood loss and lower postoperative complication rate than those in the multi-portal VATS group (P<0.05). Conclusion     In order to improve the rate of diagnosis, the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients (especially those with solid cystic and solid lesions in the lower lobe). Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.

Particle size and surface properties are crucial for lymphatic drainage(LN),dendritic cell(DC)uptake,DC maturation,and antigen cross-presentation induced by nanovaccine injection,which lead to an effective cell-mediated immune response.However,the manner in which the particle size and surface properties of vaccine carriers such as mesoporous silica nanoparticles(MSNs)affect this immune response is un-known.We prepared 50,100,and 200 nm of MSNs that adsorbed ovalbumin antigen(OVA)while modifying β-glucan to enhance immunogenicity.The results revealed that these MSNs with different particle sizes were just as efficient in vitro,and MSNs with β-glucan modification demonstrated higher efficacy.However,the in vivo results indicated that MSNs with smaller particle sizes have stronger lymphatic targeting efficiency and a greater ability to promote the maturation of DCs.The results also indicate that β-glucan-modified MSN,with a particle size of-100 nm,has a great potential as a vaccine delivery vehicle and immune adjuvant and offers a novel approach for the delivery of multiple thera-peutic agents that target other lymph-mediated diseases.

Particle size and surface properties are crucial for lymphatic drainage (LN), dendritic cell (DC) uptake, DC maturation, and antigen cross-presentation induced by nanovaccine injection, which lead to an effective cell-mediated immune response. However, the manner in which the particle size and surface properties of vaccine carriers such as mesoporous silica nanoparticles (MSNs) affect this immune response is unknown. We prepared 50, 100, and 200 nm of MSNs that adsorbed ovalbumin antigen (OVA) while modifying β-glucan to enhance immunogenicity. The results revealed that these MSNs with different particle sizes were just as efficient in vitro, and MSNs with β-glucan modification demonstrated higher efficacy. However, the in vivo results indicated that MSNs with smaller particle sizes have stronger lymphatic targeting efficiency and a greater ability to promote the maturation of DCs. The results also indicate that β-glucan-modified MSN, with a particle size of ∼100 nm, has a great potential as a vaccine delivery vehicle and immune adjuvant and offers a novel approach for the delivery of multiple therapeutic agents that target other lymph-mediated diseases.

Objective:To explore the relationship between bullying and depressive symptoms in college students,the mediating role of mobile phone addiction and the moderating role of gender.Methods:Totally 1 499 college students in Nantong City were selected to evaluate bullying experience,mobile phone addiction tendency and depressive symptoms with the Revised Adolescent Peer Relations Instrument-Bully and Target(RAPRI-T),Smart-phone Addiction Scale-Short Version(SAS-SV),Patient Health Questionnaire Depression 9-item(PHQ-9).SPSS macro program PROCESS 3.2 was used to examine the mediating role of mobile phone addiction and the modera-ting role of gender.Results:Different forms of bullying,traditional verbal bullying had the highest detection rate.There were positive correlations among bullying and the scores of SAS-SV and PHQ-9(r=0.17-0.42,Ps＜0.001).In the relationship between bullying scores and PHQ-9 scores,SAS-SV scores played a partial mediating role,and the mediating effect accounts for 26.70％of the total effect.The interaction terms between bullying and genders had statistical significance with PHQ-9 scores(β=0.09,P＜0.001),as the bullying scores increased,the PHQ-9 scores were higher in girls than in boys.Conclusion:Mobile phone addiction plays a partial mediating role in the association between bullying and depressive symptomsin college students,and the association between bull-ying and depressive symptoms is moderated by gender factors.

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Objective:To retrospectively analyze the clinical outcomes of single unrelated cord blood transplantation (UCBT) in children with high risk and refractory acute myeloid leukemia (AML) .Methods:Between June 2008 and December 2018, a total of 160 consecutive pediatric patients with AML received single UCBT (excluding acute promyelocytic leukemia) . Myeloablative conditioning (MAC) regimen were applied. All patients received a combination of cyclosporine A (CsA) and mycophenolate mofetil (MMF) for the prophylaxis of graft -versus- host disease (GVHD) .Results:The cumulative incidence of neutrophil cells engraftment at day +42 and platelet recovery at day +120 was 95.0% (95% CI 90.0%-97.5%) at a median of 16 days after transplantation (range, 11-38 days) and 85.5% (95% CI 83.3%-93.4%) with a median time to recovery of 35 days (range, 13-158) , respectively. Incidence of grades Ⅱ-Ⅳ and Ⅲ-Ⅳ acute GVHD and chronic GVHD were 37.3% (95%CI 29.3%-45.2%) , 27.3% (95% CI 20.0%-35.0%) and 22.4% (95% CI 15.5%-28.7%) , respectively. The transplant-related mortality (TRM) at 360 day was 13.1% (95% CI 8.4%-18.9%) . The 5-year cumulative incidence of relapse was 13.8% (95% CI 8.5%-20.3%) . The 5-year disease-free survival (DFS) and overall survival (OS) were 71.7% (95% CI 62.7%-77.8%) and 72.2% (95% CI 64.1%-78.7%) , respectively. The 5-year GVHD and relapse free survival (GRFS) was 56.1% (95% CI 46.1%-64.9%) . The 5-year cumulative recurrence rates of CR1, CR2, and NR groups were 5.3%, 19.9%, and 30.9% ( P=0.001) , and the 5-year OS rates were 79.9% (95% CI 70.3%-86.7%) , 71.1% (95% CI 50.4%-84.4%) and 52.9% (95% CI 33.0%-69.3%) ( χ2=7.552, P=0.020) , respectively. Conclusions:For pediatric patients with high risk and refractory AML, UCBT is a safe and effective treatment option, and it is favorable to improve the survival rate in CR1 stage.

ObjectiveTo explore the effect of psychological strengths on life satisfaction among university students， and to analyze the mediating roles of general self-efficacy and coping style. MethodsA random sample of 913 undergraduates and postgraduates from a university in Zhejiang were enrolled， and completed an online questionnaire including Strengths Knowledge and Strength Use Scale （SKSUS）， Coping Inventory for Stressful Situations （CISS）， General Self-Efficacy Scale （GSES） and Satisfaction with Life Scale （SWLS）. Then the mediating effect analysis was conducted using Bootstrapping method. Results① Strength knowledge， strength use， task-oriented coping style and GSES scores were positively correlated with SWLS score （r=0.390， 0.522， 0.345， 0.500， P<0.01）. ② Strength use， task-oriented coping style and general self-efficacy acted as mediators between strength knowledge and life satisfaction （the indirect effect was 0.387， accounting for 96.03% of the total effect）. ③ Emotion-oriented coping style acted as mediator between strength knowledge， strength use and life satisfaction （the indirect effect was 0.011， accounting for 2.73% of the total effect）. ConclusionStrength knowledge may affect life satisfaction of college students through the mediating effects of strength use， task-oriented coping style， emotion-oriented coping style and general self-efficacy.

Objective:To evaluate the feasibility and safety of uniportal video-assisted thorascopic pneumonectomy for non-small cell lung cancer patients, as well as the surgical techniques.Methods:From January 2017 to June 2018, 23 non-small cell lung cancer patients who underwent uniportal VATS pneumonectomy in our hospotal were retrospectively evaluated. There were 20 males and 3 females with a mean age of(60.3±6.0) years. The clinical data, complications and operative mortality were analyzed.Results:All 23 patients with lung cancer were operated safely. There was no conversion to thoracotomy. The mean operating time was(160.8±65.0) min. The mean blood loss was(131.3±121.3) ml. The mean hospital stays were(14.0±6.3) days. The mean postoperative hospital stays were(8.0±4.5) days. Postoperative morbidity occurred in 4 patients(17.4%). There was no perioperative mortality. Pathology examination of all patients were lung cancer(5 cases of adenocarcinoma, 15 cases of squamous carcinoma, 2 cases of large cell carcinom, 1 case of adenocarcinoma combined with large cell carcinoma).Conclusion:Uniportal video-assisted thorascopic pneumonectomy is a feasible operation that could be performed safely in a selected group of patients by experienced surgeons.