Objective To explore the diagnosis and treatment method of peripelvic cysts.Methods A retrospective analysis was conducted on 65 patients with peripelvic cysts admitted to the Department of Urology at Shanghai Xuhui Central Hospital from January 2019 to January 2023.The diagnostic value of ultrasound,intravenous urography(IVU),and computed tomography urography(CTU)for peripelvic cysts was compared,and the efficacy of different surgical treatments for peripelvic cysts was further evaluated.Results All 65 patients underwent ultrasound examination,which indicated cystic lesions at the renal hilum.55 patients underwent IVU examination,but no cyst enhancement was found.Among them,7 patients underwent retrograde pyelography due to poor imaging of the affected renal pelvis.All 53 patients who underwent CTU examination,which clearly showed the renal pelvis and cysts.Among the 65 patients,5 did not undergo surgical treatment and were followed up,while 60 underwent surgery.Four patients were considered for radical nephrectomy due to suspected malignancy.56 cases underwent renal cysts decompression surgery,including 11 open surgeries,37 laparoscopic surgeries,and 8 Da Vinci robot-assisted laparoscopic surgeries.The operative time in the open surgery group was significantly shorter than that in the laparoscopic surgery group and robot-assisted laparoscopic surgery group.Compared with the open surgery group and laparoscopic surgery group,the robot-assisted laparoscopic surgery group had less intraoperative blood loss,lower postoperative analgesic use,shorter time to first ambulation after surgery,and shorter hospital stay.Conclusions Ultrasound,IVU,and CTU are commonly used effective diagnostic tools for peripelvic cysts.Ultrasound can be used as a routine examination,while CTU is more accurate and has a higher diagnostic accuracy than IVU for this condition.Compared with open surgery,laparoscopic and robot-assisted laparoscopic cyst decompression surgery for peripelvic cysts result in less intraoperative blood loss and faster postoperative recovery.

The clinical practice guidelines of traditional Chinese medicine （TCM） have problems such as limited clinical application and unclear implementation effects， which may be related to the lack of clinical practice evidence. To provide reliable and precise evidence for clinical practice， this article proposes a model of combining TCM guidelines with real-world study， which includes 4 steps. Firstly， during the implementation process of the guidelines， a high-quality research database is established. Secondly， the recommendations in the guidelines are evaluated based on the established database in multiple dimensions， including applicability， effectiveness， safety， and cost-effectiveness， and thus their effectiveness in practical applications can be determined. Thirdly， based on the established database， core prescriptions are identified， and the targeted populations and medication plans are determined. That is， the best treatment regimen is established based on the analysis of abundant clinical data regarding the effects of different medication frequencies， dosages， and duration on efficacy. Fourthly， the guidelines are updated according to the real-world evidence. The research based on this model can provide real-world evidence for ancient and empirical prescriptions， improving their application in clinical practice. Moreover， this model can reduce research costs and improve research efficiency. When applying this model， researchers need to pay attention to the quality of real-world evidence， ensuring that it can truly reflect the situation in clinical practice. In addition， importance should be attached to the clinical application of guideline recommendations， ensuring that doctors can conduct standardized diagnosis and treatment according to the guidelines. Finally， full-process participation of multidisciplinary experts is encouraged to ensure the comprehensiveness and scientificity of the study. In conclusion， the application of this model will contribute to the development of TCM guidelines responsive to the needs of clinical practice and achieve the goal of promoting the homogenization of TCM clinical diagnosis and treatment.

The classification of traditional Chinese medicine （TCM） syndromes is one of the core technical elements in the industry standard of Specification of Diagnosis and Therapeutic Effect Evaluation of Diseases and Syndromes in TCM. In the past，when clinical standards for TCM were formulated，the determination of TCM syndrome classification relied heavily on textbooks and expert experience，lacking systematic research. This approach thus failed to reflect the advancement and scientificity of the standards，thereby affecting their implementation and application. This article reviewed the presentation forms and technical methods of TCM syndrome classification，including the two-tier syndrome classification model with primary and secondary symptoms，as well as the application of modern literature research，ancient literature research，Delphi method，in-depth expert interviews，consensus conferences，and real-world research. When syndrome classification standards are developed，it is necessary to build upon modern literature research，adopt a mixed approach combining qualitative research and quantitative analysis results，and reach expert consensus through consensus conferences. Through systematic research，the scientificity，applicability，and coordination of TCM syndrome classification standards can be enhanced，providing guidance for the standardization of TCM.

Objective:To explore the cleansing effect of Nitric Oxide (NO) sustained-release silica nanoparticles (short for NO sustained-release agent) on endoscopic biofilm and its clinical application.Methods:A total of 160 clinical endoscopes were randomly divided into two groups: the cleansing agent group (80 pieces, disinfected with cleansing agents), NO group (80 pieces, disinfected with NO sustained-release agent). A biofilm model of Pseudomonas aeruginosa was constructed and used as the control for phosphate buffered solution (PBS) treatment. A biofilm model of Pseudomonas aeruginosa on the surface of endoscopic lumen was built first in vitro. Scanning electron microscopy was then used to observe the microstructure of biofilm after treatment with NO sustained-release agent. Viable counting method was used to evaluate the cleansing effect of NO sustained-release agent on biofilm. Finally, at the clinical level, the actual disinfection effect of NO sustained-release agent on clinical endoscopy was evaluated by detecting the protein residues, viable counting and adenosine triphosphate (ATP) biofluorescence detection. Results:The scanning electron microscopy showed that the biofilm was intact in the model group, but scattered bacteria were observed on the biofilm surface in the NO group and the detergent group. Compared with the model group [(4.86±2.67)×10 6(colony-forming units, CFU)/mL], the standard CFUs of the NO group [(1.37±0.61)×10 4CFU/mL] and the detergent group [(1.31±0.21)×10 5CFU/mL] were significantly lower (detergent group VS model group, P=0.009; NO group VS model group, P=0.008), and there was significant difference between the detergent group and the model group ( t=9.53, P=0.000 6). The levels of residual proteins in the endoscopic lumens before and after the treatment were 8.03±1.47 mg/mL and 0.50±0.37 mg/mL in the NO group, 8.01±1.51 mg/mL and 0.91±0.52 mg/mL in the detergent group with significant difference ( P<0.01), and the reduction effect of the NO group was more significant. The disinfection of NO group and cleaning agent group was within the qualifying range, but the ATP bioluminescence value, protein residue and colony count of NO group (78.56±42.59 RLU, 0.50±0.37 mg/mL, 7.55±4.56 CFU) were significantly lower than those of detergent agent group (120.80±54.00 RLU,0.91±0.52 mg/mL,11.50±4.75 CFU, P<0.01). Conclusion:NO sustained-release agent can effectively clear endoscopic biofilm and further improve the disinfection effect on endoscopes, which may be of great significance for improving the effects on treatment and prognosis of patients.

Objective:To preliminarily estimate and study the effect of nucleic acid testing in blood screening on the residual risk (RR) of transfusion transmitted HBV infection (TTI HBV).Methods:Using the NAT yield/WP ratio model and adopting the relevant data of information management system of practice comparison working party in the Mainland of China, this paper analyzed the trend of the RR of TTI HBV among 18 blood centers from 2015 to 2019 in China, and compared the impact of two kinds of blood screening strategies which were ELISA+ ID-NAT/MP-NAT (individual-donation nucleic acid testing or mini-pool nucleic acid testing) and ELISA + MP-NAT on RR in 2019.Results:The overall trends of the 5-year RR of HBV among 18 blood centers showed by trend chi square test were NAT single positive rate trend χ2= 39.42( P<0.01) and residual risk trend χ2= 279.792( P<0.01); The influence on RR from the differences of ELISA+ ID-NAT/MP-NAT and ELISA+ MP-NAT was statistically significant, and chi square test showed that χ2= 7.4( P<0.01). Conclusions:Since the implementation of nucleic acid testing in the blood screening in China from 2015, the residual risk of transfusion transmitted HBV infection has decreased year by year. The observed two blood screening strategies which dominated in China may lead to discrepancy in the residual risk of TTI.

Objective:To understand the supportive care needs of patients with prostate cancer during their illness, so as to construct the supportive care needs intervention program.Methods:Purposive sampling method was used to conduct semi-structured interviews on 17 patients with prostate cancer from June 2019 to January 2020 in Haikou Hospital of Xiangya Affiliated Hospital of Central South University, and the data were analyzed by content analysis method.Results:Seven themes were extracted: the need of health information, the need of social support, the need of health care services, psychological and emotional need, the need of symptom management, the need of economic support and disease specific need.Conclusions:Patients with prostate cancer have multiple supportive care needs. The results of this study could be important reference for medical staff to provide comprehensive, personalized and humanistic care for patients and improve patients′ the quality of life and medical experience.

OBJECTIVES: Inflammation especially the overexpression of inflammasome and inflammatory cytokines, is one of the important reasons that affect the occurrence and development of acute cerebral infarction, including the initiation of cerebral infarction, the progress and recovery of post-infarction injury. This study aims to explore expressions of absent in melanoma 2 (AIM2), interleukin-1β (IL-1β), and interleukin-18 (IL-18) in plasma of patients with acute cerebral infarction and its significance. METHODS: A total of 85 patients with acute cerebral infarction were enrolled in the cerebral infarction group. They were assigned into mild, moderate, and severe groups according to the severity of neurological deficits. They were assigned into small, middle, and large cerebral infarction groups according to the area of cerebral infarction. They were assigned into a good prognosis group and a poor prognosis group according to the Modified Rankin Scale (mRS) score on the 90th day after the onset. A total of 85 healthy controls were selected as a control group. The levels of AIM2, IL-1β, and IL-18 in plasma of the cerebral group and the control group were detected by enzyme-linked immunosorbent assay (ELISA). RESULTS: The levels of plasma AIM2, IL-1β, and IL-18 in the cerebral infarction group were significantly higher than those in the control group (all CONCLUSIONS Expressions of AIM2, IL-1β, and IL-18 are up-regulated in the plasma of patients with acute cerebral infarction, and they are closely related to the severity of neurological deficit, cerebral infarction area, and prognosis in patients with acute cerebral infarction, suggesting that AIM2, IL-1β, and IL-18 may play an important role in the occurrence and development of acute cerebral infarction.
Cerebral Infarction ; DNA-Binding Proteins ; Humans ; Interleukin-18 ; Interleukin-1beta ; Melanoma ; Plasma ; Stroke

Objective:To explore the influence of mind map based nursing mode on psychological status and prognosis of patients undergoing thoracoscopic and laparoscopic esophagectomy.Methods:A total of 116 patients who underwent thoracoscopic laparoscopic esophageal cancer resection in Sanya People′s Hospital, Hainan Province from November 2017 to October 2019 were selected. According to the admission time, all patients were divided into control group and observation group, with 58 cases in each group. The patients in the control group used conventional nursing strategies, and the observation group used the method of relying on mind mapping on the basis of conventional strategies to assist nursing intervention. The negative emotions and coping styles of the two groups at admission and discharge, as well as the ICU re-occupancy rate, unplanned extubation rate, and satisfaction with nursing intervention between the two groups were compared.Results:At admission, there was no significant difference in Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale(SDS) scores between the two groups ( P>0.05). At discharge, the SAS and SDS scores of the observation group were 38.99±5.07 and 37.25±5.59, 43.25±6.49 and 41.26±4.54. The differences between the two groups were statistically significant ( t values were 3.939, 4.241, all P<0.01). At admission, there was no statistically significant difference in the scores of facing, yielding, and avoiding between the two groups ( P>0.05). At discharge, the scores of face, yield, and avoidance of the observation group were 15.47±1.86, 8.92±1.16, 9.05±1.18, and the control group were 13.32±1.60, 11.11±1.56, 12.03±1.56, the differences between the two groups were statistically significant ( t values were -6.674, 8.579, 11.603, all P<0.01). The ICU re-occupancy rate and unplanned extubation rate were 1.72% (1/58) and 3.45% (2/58) in the observation group, and 13.79% (8/58) and 15.52% (9/58) in the control group, the differences were statistically significant ( χ2 values were 4.336, 4.921, all P<0.05). The observation group ′s satisfaction with nursing intervention, communication ability, professional knowledge, and disease mastery scores were 6.81±1.95, 7.02±2.01, 8.12±1.23, and the control group were 5.35±2.11, 5.71±1.87, 6.21±0.99, the differences were statistically significant ( t values were -3.870, -3.634, -9.213, all P<0.001). Conclusions:For patients undergoing thoracic laparoscopic esophageal cancer resection, the use of mind-mapping-based nursing intervention is beneficial to improve the patient ′s psychological condition, prognosis and nursing satisfaction.

Objective To explore the effects of problem-based bedside nursing teaching in clinical teaching. Methods Totally 247 college nursing students were recruited in the study from July 2016 to June 2017. The 118 students were in the experimental group which implemented problem-based bedside nursing teaching,while 129 students were in the control group which implemented traditional teaching.The teaching effects of two groups at the end of practice was compared with mini-CEX. Results The clinical nursing comprehensive ability of the experimental group was 6.42±1.45,the control group was 5.25±1.35,the difference was statistically significant(t=15.73,P=0.000).The clinical teaching effect of the experimental group was better than that of control group,41.53%(49/118)and 51.69%(61/118)met the requirements and reached excellence, and 62.79%(81/129)and 19.38%(25/129)in the control group.The difference was statistically significant (Z=-5.35, P=0.000). Conclusions The model of bedside teaching based on problem can significantly improve nursing students'clinical nursing comprehensive ability and improve clinical teaching effect.

Objective To study the clinical effect of chlorhexidine acetate solution for oral care in patients with endotracheal intubation. Methods From February 2017 to August 2017, 160 patients with tracheal intubation in our department were divided into the observation group (80 cases) and the control group (80 cases) by random number table method. The observation group was treated with chlorhexidine acetate solution, and the control group used the compound Borax solution for oral care. The oral condition score, the positive rate of oral bacterial culture, the incidence rate of ventilator-associated pneumonia were compared between two groups. Results In the observation group, the oral condition score and the positive rate of oral bacterial culture were 10.29 ± 2.04 and 16.25% (13/80) on the 3rd day after theoral care. In the control group, the oral condition score and the positive rate of oral bacterial culture were 12.79 ± 1.97 and 31.25%(25/80) on the 3rd day after the oral care. There were statistically significant differences between the two groups (t=-7.895, P<0.01; χ2=4.970, P<0.05). The incidence and occurrence time of ventilator-associated pneumonia in the observation group were 7.50% (6/80), (9.33±1.37) d. The incidence and occurrence time of ventilator-associated pneumonia in the control group were 18.75% (15/80), (5.87 ± 1.06) d. The difference between the two groups was statistically significant (χ2=4.440, P<0.05; t=6.248, P<0.01). Conclusions The chlorhexidine acetate flushing oral care can significantly improve dental status, reduce the positive rate of oral bacterial culture and the incidence of ventilator-associated pneumonia, and prolong the occurrence time of ventilator-associated pneumonia in patients with endotracheal intubation.