Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

[摘 要] 目的：探讨miR-203a-3p对胰腺癌BxPC-3细胞增殖、迁移和侵袭能力的影响。方法：运用癌症基因组图谱（TCGA）数据库筛选胰腺癌组织和癌旁组织中差异表达的miRNA，分析miRNA高表达与低表达时胰腺癌患者的生存率和临床分期；利用TarBase数据库分析miRNA与癌症相关的GO功能与KEGG通路，利用DIANA Tools、miRDB和TargetScan网站预测miR-203a-3p的靶基因。将miR-203a-3p mimic及NC mimic、miR-203a-3p inhibitor及NC inhibitor转染至BxPC-3细胞，用qPCR法检测胰腺癌细胞和胰腺正常上皮细胞HPNE中miR-203a-3p、miR-192-5p和miR-451a表达水平，以CCK-8法、Transwell小室法和克隆形成实验分别检测BxPC-3细胞的增殖、迁移、侵袭和集落形成能力。结果：通过TCGA数据库筛选出18个胰腺癌组织中差异表达的miRNA，其中miR-203a-3p、miR-192-5p、miR-451a具有物种保守性，且其与胰腺癌临床癌症分期、细胞周期和患者生存率相关（均P<0.05）；生物信息学网站预测显示miR-203a-3p的候选靶基因是PPM1A，PPM1A与多基因存在相互作用。miR-203a-3p、miR-192-5p和miR-451a在BxPC-3和Aspc-1细胞中均高表达（均P<0.01）。miR-203a-3p mimic组BxPC-3细胞中miR-203a-3p表达水平以及细胞增殖、迁移和侵袭能力均显著提高（均P<0.01）；miR-203a-3p inhibitor组细胞中miR-203a-3p表达水平以及细胞增殖、迁移和侵袭能力均显著降低（均P<0.01）。结论：miR-203a-3p在胰腺癌组织及细胞中均高表达，其表达与患者生存和临床分期相关，可调控BxPC-3细胞的增殖、迁移和侵袭能力。

OBJECTIVE：To establis h the fingerprint of Lonicera japonica polysaccharide，and to investigate in vitro inhibitory effect of it on respiratory syndrome virus （RSV）. METHODS ：Polysaccharide from L. japonica was prepared by water extraction and twice alcohol precipitation method. After hydrolysis with trifluoroacetic acid ，derivatization with hydroxylamine hydrochloride and pyridine ，the fingerprint was established by GC method. The determination was performed on HP- 5 capillary column ，and the detector was flame ionization detector ；the temperature of the sample inlet was 250 ℃；the temperature of the detector was 300 ℃ （programmed temperature ）；the carrier gas was nitrogen （flow rate of 50 mL/min）；split sampling was adopted （split ratio of 60∶1）；the sample size was 2.0 μL. Using rhamnose as reference substance，GC fingerprint of 12 batches of L. japonica （S1-S12） was drawn ，and the similarity evaluation was performed with Similarity Evaluation System of TCM Fingerprint （2012 edition）. Cluster analysis and principal component analysis were conducted by using SPSS 21.0 software. Using ribavirin as positive control ， half effective concentration （EC50）and treatment index （TI）as indexes ，MTT assay was used to investigate in vitro inhibitory effect of L. japonica polysaccharide on RSV. RESULTS ：There were 12 common peaks in GC fingerprint of 12 batches of L. japonica. The similarity was greater than or equal to 0.994. Seven common peaks were identified ，such as rhamnose ，arabinose， fucose，mannose，glucose，galactose，inositol hexaacetate. According to the cluster analysis ，12 batches of samples could be divided into two categories ，i.e. S 1，S7，S10 and S 11 clustered into one category ，and others clustered into one category. In principal component analysis ，the eigen values of 3 principal components were all greater than 1 （5.659，2.745，1.724 respectively），and their cumulative contribution rate was 84.400％. The comprehensive score of S 12 was the highest ，the second was S 5，and the lowest was S 11. EC 50 of total polysaccharide ，80％ alcohol precipitated polysaccharide ，50％ alcohol precipitated polysaccharide and 20％ alcohol precipitated polysaccharide of L. japonica （No. S 12） were 0.76，0.61，1.03，3.04 g/L， respectively；TI were 15.36，18.51，11.69，4.22，respectively. EC 50 of 80％ ethanol alcohol precipitated polysaccharide was the lowest，and its TI was close to that of positive control （20.08）. CONCLUSIONS ：Established fingerprint provides reference for the quality evaluation of L. japonica . L. japonica polysaccharide has a certain inhibitory activity on RSV in vitro ，and the 80％ alcohol precipitated polysaccharide has the strongest activity.

Objective: To explore the clinical value of new rapid pathological diagnosis technology in the examination of cervical lesions in primary medical institution. Methods: In the Affiliated Hospital of Yangzhou University, 25 cases of cervical scraping and 22 cases of cervical biopsy were selected.Twenty-five cases of cervical scraping scraped two wipers during operation, the results were compared with conventional pathological techniques and new rapid pathological diagnosis techniques.Twenty-two cases of cervical biopsy used a new rapid pathological diagnosis technique to perform cytological diagnosis of biopsy tissue rolls in biopsy operation.According to the results of rapid pathological diagnosis, the biopsy operation plan was adjusted to analyze the clinical value of the new rapid pathological diagnosis technique in cervical lesions in primary medical institution. Results: The new rapid pathological diagnosis technology required less space and no pollution, and the diagnosis took about 2-3 min, which did not affect the normal inspection operation.Twenty-five cases of cervical scraping were produced with new rapid pathological diagnosis technique, and the quality of cervical scraping produced with conventional pathological technique was consistent, which could satisfy the needs of pathological cytological diagnosis; twenty-two cases of cervical biopsy under the vaginal device were assisted by this technology and it could increase the positive rate of the first biopsy. Conclusion Cervical scraping and cervical biopsy are still the main methods for cervical lesions examination in primary hospitals.The new rapid pathological diagnosis technology can provide the real-time pathological diagnosis of cervical scraping, improve the positive detection rate of the first biopsy of cervical biopsy, and the cost is low, suitable for promotion in primary medical institution.

With the rapid development of nanotechnology,nanomaterials have received more and more attention in the application of medical transformation researches.As a new type of multifunctional inorganic nanomaterial with particle size between 1 to 100 nm,zinc oxide nanoparticles not only has common nano-effects including high specific surface area,quantum size and macroscopic tunneling,but also has some important special effects in optical,catalytic and biological aspects showing a wide range of application prospects.In recent years,with the deepening of the physicochemical properties and special effects of zinc oxide nanoparticles,its application in biomedical fields has gradually become a research hotspot in the field of biomedicine,such as molecular fluorescence probe,antibacterial,biosensor,drug carrier,and photochemical therapy of tumor.In this paper,the special effects of zinc oxide nanoparticles on optical,catalytic and biological aspects were highlighted,and its research progress was reviewed in medical imaging applications such as molecular imaging localization,biosignal sensing and molecular recognition,drug carrier development and tumor therapy.Furthermore,the problems in the translational application of zinc oxide nanoparticles were discussed.

Objective To observe the effect of FOCUS-PDCA on the unplanned extubation (UEX) in ICU patients. Methods About 237 ICU patients during Jan. to Dec. 2014 were assigned as the control group, where the FOCUS-PDCA program was not used. Another 235 patients during Jan. to Dec. 2015 were assigned as the study group, where the the FOCUS-PDCA program was used. The two groups were compared in view of unplanned extubation rate and nurse's comprehensive ability. Result Compared with the control group, hospitalization time was comprehensively shortened in the observation group and the nurses comprehensive abibity increased (all P<0.05). Conclusion The FOCUS-PDCA program can prevent UEX in ICU patients, reduce the rate of UEX, improve the comprehensive ability of nurses and the quality of nursing.

Objective To discuss the application effects of case-based learning combined with tutor responsibility system teaching method on orthopedic specialist nurse training.Methods A total of 43 orthopedic specialist nurses who were admitted in 2014 and 2015 received the case-based learning combined with tutor responsibility system teaching method training. After the training, the theoretical examination, the project defense and the Competency Inventory for Registered Nurse(CIRN) were applied to evaluate the efficacy of the training.Results All 43 orthopedic specialist nurses passed the theoretical and clinical examination successfully and had the orthopedic specialist nurse certificate after the defense. The total score after the training was (178.88±25.95), which was significantly higher than the score (158.64±24.97) before the training (t=3.687, P<0.05).Conclusions The case-based learning combined with tutor responsibility system teaching method can improve orthopedic specialist nurses' core competence, clinical ability and research capacity so as to lay the foundation for further specialist nurse training.

OBJECTIVENon-invasive positive pressure ventilation has increasingly been chosen as the primary ventilation mode in respiratory distress syndrome (RDS) in preterm infants. In order to further understand the application of various non-invasive positive pressure ventilation modes, we compared the advantages and disadvantages of three modes as a primary mode of ventilation in premature infants with RDS.

METHODFrom December 2011 to March 2013, 107 preterm infants with RDS who received intubation-pulmonary surfactant (PS) -extubation in our NICU were randomly divided (by means of random number table) into three groups based on the primary mode of ventilation: nasal continuous positive airway pressure [NCPAP, n = 39, male/female ratio was 27/12, mean gestational age (GA) was (32.0 ± 2.1)weeks, mean birth weight (BW) was (1752 ± 457)g], bi-level positive airway pressure [BiPAP, n = 35, male/female ratio was 25/10, GA was (31.4 ± 2.0) weeks, BW was (1530 ± 318) g], and synchronized bi-level positive airway pressure [SBiPAP, n = 33, male/female rate was 25/8, GA was (31.5 ± 2.2) weeks, BW was (1622 ± 447) g]. Ventilation settings including FiO(2) were adjusted according to transcutaneous SPO(2) monitoring or blood gas analysis. Various settings and adverse events were recorded as well. The main parameter was the FiO(2) at 24 h post-positive-pressure ventilation. Statistical analyses were performed using χ(2) test, rank sum test, one-way analysis of variance for least-significant difference value, paired-sample t-test, two related sample Wilcoxon signed rank sum test and Logistic regression.

RESULTThe PaCO(2) (mmHg, 1 mmHg = 0.133 kPa), oxygen index (OI) at 12-24 h, and FiO(2) at 24 h post-ventilation in BiPAP and SBiPAP groups were lower than that in NCPAP groups with significant difference (44 ± 9 and 45 ± 9 vs. 50 ± 9, 2.76 ± 0.96 and 2.79 ± 0.60 vs. 3.24 ± 0.72, 0.34 ± 0.10 and 0.35 ± 0.07 vs. 0.39 ± 0.07; F = 4.456, 5.146 and 4.123; P = 0.014, 0.007 and 0.019, respectively). There was no significant difference between BiPAP and SBiPAP groups. There was no significant difference among three groups (all P > 0.05) in the following events: respiratory index (RI) at 12-24 h post-ventilation, abdominal distension, period of non-invasive ventilation, ratio of intubation for invasive ventilation if failed noninvasive ventilation, air-leak syndrome, neonatal necrotizing enterocolitis, periventricular-intraventricular haemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity, mortality rate after 36 h of age or rate of abandon for discharge. The independent risk factors for failure of non-invasive positive pressure ventilation were gender, gestational age, antepartum steroid at 24 h before birth to 7 d, and birth weight, with the OR (95% confidence interval) being 14.120 (1.135, 175.662), 2.862 (1.479, 5.535), 61.084 (3.115, 1 198.031), and 8.306 (1.488, 46.383), respectively.

CONCLUSIONAs the primary mode of ventilation in premature infants with RDS, both BiPAP and SBiPAP are more beneficial than NCPAP in improving oxygenation and reducing CO(2) retention without increasing the incidence of adverse events.

Blood Gas Analysis ; Carbon Dioxide ; blood ; Continuous Positive Airway Pressure ; methods ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intubation, Intratracheal ; Male ; Oxygen ; blood ; Pulmonary Surfactants ; therapeutic use ; Respiratory Distress Syndrome, Newborn ; therapy ; Risk Factors ; Treatment Outcome ; Ventilator Weaning

Objective To investigate the mRNA expression of breast cancer resistance protein (BCRP) in cervical cancer (CC).Methods The expression of BCRP mRNA was detected by real-time PCR from tissues of 12 normal and 47 cases with CC.Results The expression of BCRP mRNA was 0.59±0.26 in CC and 0.19±0.17 in normal cervical tissues.But it was significantly higher in CC than those in normal tissues (P ＜ 0.05).The expression of BCRP mRNA was not correlated with histological types,tumor differentiation degree and clinical stages (P ＞ 0.05).Conclusion BCRP mRNA over-expresses in CC,wich might play a major role in the intrinsic MDR of CC.Detection of BCRP mRNA expression may the guidance of individualized chemotherapy for patients with CC.

Objective To investigate the expression of connective tissue growth factor(CTGF),coll agen I and collagen Ⅲ in sacroiliac joint(SIJ)of patients with spondyloarthropathy(SpA).Methods Thirty patients with SpA,including 17 patients with grade Ⅱ saeroiliitis and 13 patients with grade Ⅰ sacroiliitis,were performed on CT guided needie biopsy of SIJ.After sacroiliitis were confirmed by staining with hematoxylin and eosin in sacroiliac joint tissue sample,immunohistochemical assay was performed to determine the expression of CTGF,collagen Ⅰ and collagen Ⅲ in sacroiliac ioint tissue.Univariate Chi-square test was used for data comparison between multiple groups and t-test was used for two group data comparison.Results Contrast to healthy controls,CTGF were found upexpressed on the cytoplasm of inflammatory cells in pannus and bone marrow of sacroiliac tissue samples of patients with SpA,while collagen I and collagen Ⅲ were found up-expressed in bone,cartilage and ligament tissue[(57.9±42.4)/HP vs(2.7±2.5)/HP P<0.05,0.298±0.080 vs 0.044±0.024 and 28.254±41.165 vs 0.105±0.054.P<0.05 respectively].Conclusion CTGF,collagen Ⅰ and collagen Ⅲ are up-expressed in SIJ of SpA patients.CTGF may play an important role in articular cartilage fibrosis and ossification of SpA.