To summarize the nursing care of a very low birth weight premature infant with severe type Ⅱbronchopulmonary dysplasia(BPD)during the transition period from hospitalization to home.The care of the infant was provided one-on-one by a BPD specialist nurse throughout the period.The key points of transitional care from hospitalization to home include:implementing tracheotomy and mechanical ventilation care to ensure stable blood oxygen saturation of the infant;providing nutritional support to improve the nutritional status of the infant;implementing step-by-step rehabilitation measures to improve the neuromotor development of the infant;implementing family integrated care to promote the primary caregivers of the infant to master nursing knowledge and skills;conducting personalized discharge follow-up with a multidisciplinary team to improve the quality of home care for this infant.After being hospitalized for 106 days,the infant was successfully discharged with a tracheotomy tube.At the age of 2 years and 6 months,a tracheotomy closure surgery was performed.After the surgery,the infant was able to breathe autonomously without symptoms of breathing difficulties and returned to normal family life.

Objective:To observe the effects of Sanjia Powder on myocardial fibrosis in diabetic cardiomyopathy (DCM) model rats; To elaborate its mechanism.Methods:A DCM rat model was constructed using STZ single intraperitoneal injection combined with high-sugar and high-fat feeding. The model rats were divided into model group, TCM group, Western medicine group, miR-21 inhibition group, and miR-21 inhibition control group using a random number table method, with 10 rats in each group; another 10 SD rats were set as normal group. TCM group was orally administered with Sanjia Powder water decoction at a dose of 6.2 g/kg, and the Western medicine group was administered metformin 250 mg/kg + enalapril 45 mg/kg by gavage. miR-21 inhibition group, miR-21 inhibition control group, normal group, and model group were given the same volume of distilled water by gavage, once a day, for 4 weeks; at the same time, the normal group, the model group, TCM group, and the Western medicine group were injected with the same amount of normal saline in the tail vein. The miR-21 inhibition group received tail vein injection of miR-21 inhibitor at a dose of 20 mg/kg, and the miR-21 inhibition control group received tail vein injection of miR-21 inhibitor NC at a dose of 20 mg/kg, twice a week, for 4 weeks. The morphological changes of myocardial tissue were observed using HE; the expression of Collagen-Ⅰ in myocardial tissue was detected using Western Blot; the expressions of endothelial cell marker CD31 and stromal cell marker FSP1 in myocardial tissue were detected using immunofluorescence method.Results:Compared with the model group, the pathological morphology of myocardial tissue improved in the TCM group, Western medicine group, and miR-21 inhibition group, while the expressions of Collagen-Ⅰ and FSP1 decreased ( P<0.01) and the expression of CD31 increased ( P<0.01); there was no statistically significant difference in the expressions of Collagen-Ⅰ, CD31, and FSP1 between the TCM group and the miR-21 inhibition group ( P>0.05). Conclusion:Sanjia Powder can improve myocardial fibrosis in rats with diabetic cardiomyopathy, and its mechanism may be related to the up-regulation of CD31 expression and down-regulation of FSP1 expression, thereby inhibiting endothelial mesenchymal transition, and may also be related to the inhibition of miR-21 expression.

Objective To evaluate the scientificity,transparency and applicability of Chinese guidelines and expert consensuses on nursing published in 2022,in order to improve the quality of guidelines and consensuses.Methods Databases including Medline,Embase,Web of Science,CBM,CNKI,WanFang database,Chinese Medical Journal,and related websites were electronically searched,as well as China Hong Kong,Macao and Taiwan medical journals,to collect Chinese guidelines and expert consensuses on nursing from January to December 2022.STAR tool was used to evaluate the quality of each guidelines and consensuses by 3 assessors independently.Total score,scoring rate of each domain and item were adopted to analyze the outcomes.Results A total of 3 guidelines and 33 expert consensuses were included.The total guidelines and expert consensuses STAR score(33.5±14.3).The quality of guidelines and consensuses was low.The quality of guidelines was moderate with average score of 55.1,and the quality of consensuses was low with average score of 31.5.The included guidelines and consensuses had a highest score rate(52.4％)in the domain of recommendation.Among 39 items of STAR tool,the top 4 items including listing participants and institutions,explaining additional instructions for implementation,describing consensus method,and listing references for recommendations had a high score rate of 100％,83.3％,77.8％,75.0％respectively.However,the items of registration,providing registration information,protocols being searched on public platforms and explaining the role of funding had a low score rate,urgent need for attention and upgrading.Conclusion The overall quality of the Chinese guidelines and expert consensuses on nursing published in 2022 was low.As a medical and nursing practice guidance document,the quality of guidelines and expert consensuses should be improved by encouraging registration,strengthening management of interest conflict,enhancing the rigor of guideline developing process,and expanding the dissemination.

The extremely low bioavailability of oral paclitaxel (PTX) mainly due to the complicated gastrointestinal environment, the obstruction of intestinal mucus layer and epithelium barrier. Thus, it is of great significance to construct a coordinative delivery system which can overcome multiple intestinal physicochemical obstacles simultaneously. In this work, a high-density PEGylation-based glycocholic acid-decorated micelles (PTX@GNPs) was constructed by a novel polymer, 9-Fluorenylmethoxycarbonyl-polyethylene glycocholic acid (Fmoc-PEG-GCA). The Fmoc motif in this polymer could encapsulate PTX via π‒π stacking to form the core of micelles, and the low molecular weight and non-long hydrophobic chain of Fmoc ensures the high-density of PEG. Based on this versatile and flexible carriers, PTX@GNPs possess mucus trapping escape ability due to the flexible PEG, and excellent intestine epithelium targeting attributed to the high affinity of GCA with apical sodium-dependent bile acid transporter. The in vitro and in vivo results showed that this oral micelle could enhance oral bioavailability of PTX, and exhibited similar antitumor efficacy to Taxol injection via intravenous route. In addition, oral PTX@GNPs administered with lower dosage within shorter interval could increase in vivo retention time of PTX, which supposed to remodel immune microenvironment and enhance oral chemotherapy efficacy by synergistic effect.

Objective:To elucidate the drug resistance characteristics and molecular epidemiological features of carbapenem-resistant Klebsiella pneumoniae (CRKP) in this region, and to provide a basis for clinical anti-infective therapy. Methods:A total of 92 CRKP isolates were collected from the First Affiliated Hospital of Ningbo University and Ningbo No.2 Hospital. Antimicrobial susceptibility testing was performed using the VITEK2 Compact analyzer. Whole-genome sequencing was used to analyze their molecular characteristics including capsular serotypes, sequence types (multilocus sequencing typing) and resistance genes. Plasmid replicon types were identified using PlasmidFinder, and core genome phylogenetic analysis was performed with Parsnp.Results:The CRKP isolates were mainly isolated from critically ill elderly patients, with sputum (51.09%, 47/92) and urine (13.04%, 12/92) as the major specimen sources, followed by blood (8.70%, 8/92). Most of the infections were reported in the intensive care unit (33.70%, 31/92). All isolates showed high resistance to commonly used antibiotics, but lower resistance to polymyxin B (6.52%, 6/92). The predominant resistance gene, capsule serotype and ST were blaKPC-2 (78.26%, 72/92), KL64 (48.91%, 45/92), and ST11 (54.35%, 50/92), respectively. ST11-KL64 was the predominant clone, accounting for 46.74%(43/92) and carried multiple plasmids with IncR and IncFⅡ as the major types. Conclusions:CRKP in this region mainly harbored the blaKPC-2 resistance gene and showed high resistance to commonly used antibiotics. The ST11-KL64 clone spread widely in this region and the strains circulating in the two hospitals were similar. Thus, the surveillance should be strengthened.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective:To analyze the results of serum erythropoietin (EPO) in adults patients with Kaschin-Beck disease (KBD) in Qinghai Province.Methods:According to the "Diagnosis of Kaschin-Beck Disease" (WS/T 207-2010), by using clinical examination and X-ray, adults over 20 years old in KBD areas of Xinghai County and Guide County, Hainan Tibetan Autonomous Prefecture, Qinghai Province, were divided into KBD case group ( n = 109) and internal control group ( n = 95) in July 2019. At the same time, healthy people were selected as external control group ( n = 90) in Xunhua County. Then 2 ml fasting cubital venous blood was collected from the target population to separate serum. The serum EPO level was determined by enzyme-linked immunosorbent assay (ELISA). Results:There was no significant difference in age and sex ratio among the 3 groups ( F = 0.73, P = 0.484; χ 2 = 1.03, P = 0.611). There was significant difference in serum EPO levels among the 3 groups [KBD case, internal and external control groups: (30.74 ± 26.23), (19.73 ± 11.53) and (10.83 ± 4.48) U/L, F = 26.51, P < 0.001]. Multiple comparisons showed that there were statistically significant differences in serum EPO levels between KBD case group and the internal and external control groups ( P < 0.05), but there was no significant difference between the internal and external control groups ( P > 0.05). Conclusions:The serum EPO level in adult KBD patients in Qinghai Province is increased significantly.

Objective:To explore the effect of Gubi Decoction on serum related inflammatory factors and PI3K/Akt/mTOR signaling pathway in osteoarthritis model rats. Methods:Seventy SPF rats were randomly divided into the blank group, sham operation group, Glucosamine sulfate group, and the low, medium and high dose Gubi Decoction groups. Except the blank group and sham operation group, knee osteoarthritis animal models were prepared by the modified Hulth method in each group. On the 28th day after successful model preparation, the high, medium and low dose Gubi Decoction groups were given Gubi Decoction 24, 12 and 6 g/kg by gavage respectively; glucosamine sulfate group was given glucosamine sulfate tablet suspension 3 g/L by gavage, once a day for 28 days. The levels of TNF-α and IL-1β in serum were detected by ELISA. The gene expressions of PI3K, Akt and mTOR in cartilage tissue were detected by Real-PCR. The protein expressions of PI3K, Akt, p-PI3K, p-Akt and mTOR were detected by Western blot. Results:Compared with the model group, the knee joint diameter[(11.17 ± 1.81) mm, (11.60 ± 1.38) mm, (10.80 ± 1.17) mm vs. (12.57 ± 0.98) mm] of the rats in the glucosamine sulfate group and the medium and high dose Gubi Decoction groups significantly decreased ( P<0.05). The content of TNF-α [(111.43 ± 21.98) ng/L, (53.42 ± 13.25) ng/L vs. (157.89 ± 23.60) ng/L], IL-1β [(67.50 ± 18.44) ng/L, (48.22 ± 9.63) ng/L vs. (96.11 ± 14.85) ng/L] in the medium and high dose Gubi Decoction groups significantly decreased ( P<0.05), and the expression of PI3K (1.87 ± 0.17, 1.24 ± 0.49 vs. 2.19 ± 0.47), Akt (1.50 ± 0.51, 1.10 ± 0.32 vs. 2.68 ± 0.63), and mTOR (1.32 ± 0.54, 1.10 ± 0.33 vs. 2.94 ± 0.55) mRNA in the medium and high dose Gubi Decoction groups significantly decreased ( P<0.05). The expression of PI3K, Akt, p-PI3K, p-Akt in the low, medium and high dose Gubi Decoction groups significantly decreased ( P<0.05), and the expression of mTOR in the medium dose Gubi Decoction group significantly decreased ( P<0.05). Conclusion:Gubi Decoction can significantly reduce the level of inflammatory factors in the serum of osteoarthritis model rats, and its anti-inflammatory and analgesic effects may be related to PI3K/Akt/mTOR signaling pathway.

Objective:To detect serum Col2-3/4 C-terminal cleavage product of type Ⅱ collagen (C2C) and pyridinoline (PYD) among brucellosis patients at early period, and to provide a better understanding of the changes of bone and joint collagen metabolism in the early stage of brucellosis.Methods:From 2013 to 2016, 61 cases of brucellosis patients at early period (within 6 months) from brucellosisout patient of Qinghai Institute for Endemic Disease Prevention and Control were selected as case group, and 67 cases of healthy volunteers were selected as control group. Serum C2C and PYD levels in all samples were measured simultaneously with enzyme linked immunosorbent assay (ELISA).Results:The median serum C2C of patients with early brucellosis was 83.45 ng/ml and that of the control group was 73.35 ng/ml. There was significant difference in serum C2C between the case group and the control group ( Z = 5.027, P < 0.05). The median serum PYD of patients with early brucellosis was 278.45 nmol/L and that of the control group was 212.75 nmol/L. There was significant difference in serum PYD between the case group and the control group ( Z = 6.967, P < 0.05). Conclusion:Serum C2C and PYD levels of brucellosis patients at early period are increased.

Objective:To explore the application value of Jiawei Yangyin Jiedu Decoction in the treatment of epidermal growth factor receptor (EGFR)- tyrosine kinase inhibitor (TKI)- related rash of lung cancer, and observe its influence on inflammatory index and immune function of patients, aiming to provide effective treatment for this disease.Methods:From December 2016 to January 2019, 90 patients with EGFR-TKI-related rash belonging to Yin deficiency and toxic type in Traditional Chinese Medicine (TCM) syndromes in Yongkang Traditional Chinese Medicine Hospital of Zhejiang Province were included. The patients were divided into control group and observation group by random digits table method with 45 case each. The patients in control group were treated with mupirocin ointment, and the patients in observation group were treated with Jiawei Yangyin Jiedu Decoction on the basis of the control group. The clinical efficacy was compared after 4 weeks.Results:After treatment, the number of lesions and the number of sites, rash area estimation, rash color and other symptoms in observation group were significantly lower than those in control group: (0.71 ± 0.27) scores vs. (1.36 ± 0.32) scores, (0.68 ± 0.14) scores vs. (1.24 ± 0.27) scores, (0.53 ± 0.17) scores vs. (1.31 ± 0.24) scores, the total effective rate was significantly higher than that in control group: 80.00% (36/45) vs. 28.89% (13/45), and there were statistical differences ( P<0.01). The blood samples of the elbows were taken before and after treatment. The immune function indexes of CD 4+/CD 8+, CD 4+ and CD 3+ after treatment in observation group were significantly higher than those in control group: 1.46 ± 0.20 vs. 1.27 ± 0.23, 0.378 ± 0.042 vs. 0.323 ± 0.031 and 0.573 ± 0.062 vs. 0.518 ± 0.060, and there were statistical differences ( P<0.05). The levels of carcinoembryonic antigen and cancer antigen 125 after treatment in observation group were significantly lower than those in control group: (28.17 ± 8.45) μg/L vs. (35.37 ± 9.73) μg/L and (25.29 ± 6.15) kU/L vs. (36.42 ± 12.06) kU/L, the quality of daily life score was significantly higher than that in control group, and there were statistical differences ( P<0.05). After treatment, the levels of inflammatory markers such as tumor necrosis factor-α and interleukin-1β in observation group were lower than those in control group, and there were statistical differences ( P<0.05). Conclusions:For patients with lung cancer EGFR-TKI-related rash, it is important to treat them with Jiawei Yangyin Jiedu Decoction, which can reduce inflammation, improve immunity and improve rash. It is worth promoting.