Objective:To investigate the evidence-based practice of prevention and care of nasal and facial pressure injuries in patients with non-invasive positive pressure ventilation (NPPV) using the knowledge to action framework (KTA), and to explore its effectiveness.Methods:Using an evidence-based nursing approach, an evidence-based practice group was established to formulate a clinical problem, the literature from domestic and international databases were researched for relevant evidence, the evidence was introduced into clinical scenarios, an evidence-based practice plan was developed, and a strategy for applying the best evidence was constructed by conducting a baseline review of healthcare professionals and patients with NPPV, analyzing barriers and promoting factors, and making changes in clinical practice at the organizational level, the practitioner level, and the patient level. Purposive sampling method was used to select the healthcare staff of the cardiac surgical intensive care unit (CSICU) of the Shandong Provincial Hospital Affiliated to Shandong First Medical University, as well as the patients with NPPV admitted from October 1 to November 15, 2023 (pre-evidence-based practice) and November 16 to December 31 (post-evidence-based practice), as the subjects of the study. Through questionnaire analysis, the incidence of nasal and facial pressure injury of NPPV patients, the implementation rate of review indicators of medical staff, the score of the knowledge, belief and conduct of medical staff, and the compliance and comfort of patients before and after evidence-based practice were compared.Results:A total of 52 medical staff were included, aged (28.54±6.50) years old, with 3.00 (1.00, 12.75) years of working experience; 2 doctoral degree holders (3.85%), 4 master degree holders (7.69%), 46 bachelor degree holders (88.46%); 2 with senior title (3.85%), 17 with intermediate title (32.69%), and 33 junior titles (63.46%). Fifty patient questionnaires were collected before and after evidence-based nursing practice; the differences between before and after evidence-based practice in terms of gender, age, body weight, duration of ventilator usage, 24-hour bleeding and total bleeding were not statistically significant and were comparable. Compared with the pre-evidence-based practice, after carrying out the corresponding evidence-based nursing practice, the incidence of nasal and facial pressure injuries of NPPV patients decreased from 16.00% (8/50) to 4.00% (2/50, P < 0.05), the total implementation rate of review indicators of medical staff increased from 79.73% to 94.08% ( P < 0.01), and the total scores of knowledge, belief and conduct were significantly improved (141.96±13.88 vs. 114.65±19.72, P < 0.05), and compliance and comfort of patients were significantly improved (compliance score: 4.60±0.99 vs. 5.82±1.42, comfort score: 4.10±1.63 vs. 6.92±2.33, both P < 0.05]. Conclusion:The application of an evidence-based nursing approach to obtain evidence related to the prevention of nasal and facial pressure injuries in patients with NPPV can be used to guide clinical practice, significantly reducing the incidence of nasal and facial pressure injuries in such patients, improving the implementation rate of review indicators and the knowledge, belief, and conduct scores of medical staff, and enhancing compliance and comfort of NPPV patients.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective: To systematically review the diagnostic accuracies of multiplex real time polymerase chain reaction (MRT-PCR) technique for detection of respiratory syncytial virus (RSV) and adenovirus (ADV). Methods: PubMed, EMBASE, Cochrane, Wanfang and CNKI databases were searched from January1 2010 to January1 2018, to collect reports on MRT-PCR for detection of common respiratory viruses. Then two authors independently exacted the data and assessed the risk of bias of included studies by using the QUADAS-2 tool. Meta-disc 1.4. Results: Ten articles with 2528 cases were eligible for analysis. The result of meta-analysis showed that, the pooled Sen, Spe and area under SROC curve, for detecting RSV were 0.87 (95% CI 0.83 to 0.90), 0.98 (95% CI 0.97 to 0.98) and 1.00. The pooled Sen, Spe, and area under SROC curve of MRT-PCR for detecting ADV were 0.64 (95% CI 0.56 to 0.71), 0.99 (95% CI 0.98 to 0.99) and 0.99. Deeks test indicated that no publication bias was found. Conclusions The sensitivity of MRT-PCR in RSV and ADV detection is still to be improved, but the overall detection ability is good which deserves to be recommended for clinical use.

OBJECTIVE:To determine the content of urea in Urea [13C] capsules by high performance cation-exchange chroma-tography (HPCEC). METHODS:The determination was performed on Zorbax 300 SCX column with mobile phases consisting of acetonitrile-0.1% phosphoric acid (20:80,V/V) at the flow rate of 1.0 mL/min. The detection wavelength was set at 200 nm and column temperature was 35 ℃. The sample size was 20 μL. RESULTS:The linear range of urea was 0.0039-1.0030 mg/ml(r=0.9997). The limit of quantitation was 3.918 μg/mL and the limit of detection was 0.975 μg/mL. RSDs of precision,stability and repetitive test were all lower than 2.0%. The recovery ranged 99.3%-101.0%(RSD=0.67%,n=9). CONCLUSIONS:The meth-od is simple,rapid,sensitive and suitable for the content determination of urea in Urea [13C] capsules.

Objective To evaluate the efficacy and safety of PECS block under ultrasound guidance in multimodal analgesia after modified radical mastectomy.Methods Sixty female patients aged 18-65 years, ASA grade Ⅰ or Ⅱ, undergoing elective unilateral modified radical mastectomy were enrolled.Patients were randomly divided into PECS group (group P, n=30) or control group (group C, n=30).Two groups of patients were given flurbiprofen axetil 1 mg/kg via intravenous injection before operation.After general anesthesia induction, patients in group P received ultrasound guided pectoral nerves block with 30 ml of 0.375% ropivacaine.Patients in group C didn`t receive nerve block.Anesthesia maintenance was performed by combined intravenous-inhalation Anesthesia.Postoperative VAS pain scores (at 0, 3, 6, 12, and 24 postoperative hours), does of intraoperative remifentanil, rescue analgesic requirements in the first 24 h after surgery, adverse reactions were recorded.Results VAS score in group P was lower than that in group C at 0, 3, 6 and 12 h after surgery (P<0.05), there was no difference at 24 h.The dose of remifentanil and the rescue analgesic requirements in group P were lower than those in group C (P<0.05).There was no significant difference in postoperative adverse reactions between the two groups.Conclusion As a supplementary mode of multimodal analgesia, PECS block is a safe and reliable technique that provide better analgesia effect for modified radical mastectomy.

Objective To investigate the inhibitory effects of high mobility group chromosomal protein N2 (HMGN2)on growth of human bladder cancer T24 cells and ectopic tumor growth of nude mice. Methods MTT and flow cytometry assay were conducted to detect cell growth of bladder epithelial cells(T24)cells in vitro. The transplantation tumor models in nude mice were constructed by injecting T24 cells in vivo. The para-tumorswere injected with PBS,HMGN2 protein and cisdichlorodiamineplatinum(DDP),respectively. Tumor volume and weight were calculated. The expression of cell proliferation-related proteins was detected by Western blot assay. Results MTT assay proved that HMGN2 could significantly inhibit the growth of T24 cells. Flow cytometry assay verified that HMGN2 could block T24 cells in S stage of the cell cycle. The average tumor volume and weight in the HMGN2 group and DDP positive control group were smaller than those in the PBS group(P<0.05,respectively), with the tumor inhibitory rate of 25% and 23%,respectively. The results of Westernblot showed that HMGN2 could decrease Bcl-2 expression and increase Bax expression in tumor. Conclusion HMGN2 has a significant antitumor effect on T24 cells and bladder carcinoma in nude mice,which may be associated with the induction of the apoptosis of carcinoma cells and the regulation of the cell cycle.

Objective To observe the effects of dexmedetomidine (DEX) on the expressions of TNF-α, IL-1β and apoptosis-related proteins in rat mesenteric artery.Methods Male SD rats of SPF grade were sacrificed and the mesenteric artery was separated under the stereo-microscope.We established an experimental model of vascular injury induced by lipopolysaccharide (LPS) and randomly divided the injured vessels into dexmedetomidine treatment group and control group.DEX treatment group was divided into 10-8, 10-7, and 10-6 mol/L subgroups according to the different concentrations of DEX.RNA and total protein was extracted in each group.The mRNA expressions of TNF-α, IL-1β and CaSR were detected by RT-PCR and the protein expression of TNF-α, Caspase-3 and AMPK were tested by Western blot.Results DEX (10-8, 10-7, and 10-6mol/L) obviously reduced vascular inflammatory reaction induced by lipopolysaccharide, reduced the mRNA and protein expressions of TNF-α as well as mRNA expression of IL-1β.Caspase 3 protein expression significantly lowered in blood vessels in DEX group compared with LPS group.DEX had no obvious effect on lipopolysaccharide-induced vascular AMPK and CaSR mRNA or protein expressions.Conclusion DEX obviously deceased the expressions of inflammation-related proteins, suggesting that DEX has anti-inflammatory effects.

AIM: To observe the effects of miR-542-5p on the proliferation of rat small intestine crypt epithe-lial IEC-6 cells induced by sphingosine-1-phosphate (S1P).METHODS: Two IEC-6 cell lines (SphK1-IEC-C1 and SphK1-IEC-C2) were established, which expressed sphingosine kinase-1 (SphK1) stably.Radioactive tracer was used to detect SphK1 activity and S1P secretion.The cell proliferation was observed by cell counting and described by drawing growth curve, and the cell cycle analysis was carried out by flow cytometry.The level of miR-542-5p was evaluated by RT-qPCR.RESULTS: Compared with control vector cells without SphK1 cDNA, both SphK1-IEC-C1 and SphK1-IEC-C2 cell lines showed that Sphk1 was elevated, both intracellular and extracellular S1P increased dramatically, the rate of cell growth was faster, the percentage of the cells in S phase increased, and miR-542-5p expression decreased.S1P (0.5~10 μmol/L) led to the decrease in miR-542-5p expression.On the contrary, SphK1 silencing resulted in the increase in miR-542-5p expression in the IEC-6 cells.The miR-542-5p was elevated in SphK1-IEC-C1 cells and SphK1-IEC-C2 cells, which caused the decrease in the percentage of the cells in S phase.The cell growth rate in the above-mentioned 2 cell lines decreased compared with negative control group.CONCLUSION: In IEC-6 cells, S1P promotes proliferation by inhibiting miR-542-5p expression, which induces the cell cycle transferring from G1 phase to S phase.

OBJECTIVE:To determine the content of acetic acid in Octreotide acetate for injection by IEC,and provide reference for the improvement of pharmacopoeia standards. METHODS:The column was Rezex ROA-Organic Acid H+ with mobile phase of 0.002 5 mol/L sulfuric acid at a flow rate of 0.5 ml/min,the detection wavelength was 210 nm,column temperature was 45℃,and in-jection volume was 100 μl. RESULTS:The linear range of acetic acid was 0.394 4 μg/ml-78.89 μg/ml(r=0.999 9);RSDs of preci-sion,stability and reproducibility tests were all lower than 2%;the limit of quantification was 197.2 ng/ml,and limit of detection was 78.89 ng/ml;recovery was 104.71%-109.78%(RSD=1.34%,n=9). CONCLUSIONS:The method is environmental and simple with good accuracy and precision,and suitable for the content determination of acetic acid in Octreotide acetate for injection.