Objective:To establish the post competency evaluation index system for extracorporeal membrane oxygenation (ECMO) nurses.Methods:Based on semi-structured interviews, a preliminary post competency evaluation index system for ECMO nurses was developed. From May to June 2022, the Delphi method was used to conduct two rounds of consultation with 19 experts in critical illness field from 15 ClassⅢGrade A hospitals in 6 provinces and municipalities across the country to determine the evaluation index system. The analytic hierarchy process was used to determine the weights and consistency coefficients of indexes at all levels. The positivity of experts was expressed by the effective response rate of the questionnaire, the coordination degree of expert opinions was expressed by Kendall's W and coefficient of variation, the authority of experts was expressed by the authority coefficient of experts, and the concentration of expert opinion was expressed by the mean importance assignment and the perfect score rate. Results:In two rounds of expert consultations, the effective response rates of the questionnaires well all 100.00% (19/19), with expert authority coefficients of 0.834 and 0.879. The Kendall's W for the overall indicator in the second round of expert correspondence was 0.281 ( P<0.01), and the coefficient of variation of the indicators at all levels was 0.05 to 0.17. In the second round of consultation, the mean importance scores assigned to indicators at all levels was 4.05 to 4.95, with a perfect score of 21.05% to 94.74%. The final constructed post competency evaluation index system for ECMO nurses included 4 first-level indicators, 28 second-level indicators, and 59 third-level indicators. Conclusions:The post competency evaluation index system for ECMO nurses is scientific, reliable, and reasonable, which can provide reference for optimizing the ECMO nurse training system and improving evaluation standards.

Extracorporeal membrane oxygenation is an extracorporeal life support technique used to rescue patients with respiratory and (or) heart failure. Infection is one of the most serious complications of extracorporeal membrane oxygenation, which can affect patients' clinical outcomes. This article reviews the definition, diagnosis, incidence, site of infection, pathogenic bacteria, risk factors, prevention and treatment measures of extracorporeal membrane oxygenation associated nosocomial infection, so as to provide reference for the prevention and treatment of extracorporeal membrane oxygenation associated nosocomial infection.

Objective:To analyze the research status of traditional Chinese Medicine (TCM) constitution identification for hypertension and discuss the research hotspots in this field.Methods:Based on China National Knowledge Infrastructure and Wanfang data knowledge service platform, the papers on TCM constitution identification of hypertension from 2010 to 2021 were retrieved. Bibliometric software Bicomb 2.01 and gCLUTO 1.0 were used to conduct a quantitative study of the retrieved literatures.Results:A total of 836 relevant articles were retrieved, and 42 high-frequency keywords such as "hypertension" "TCM constitution" "TCM constitution identification" and "phlegm-dampness constitution" were screened out. Research hotspots includes hypertension-TCM constitution identification, correlation between hypertension-TCM constitution and risk factors, hypertension-TCM differentiation of body and diet, hypertension-TCM body differentiation and treatment and hypertension-TCM health management.Conclusions:The number of papers on TCM constitution identification for hypertension is increasing year by year, but the regional development is uneven, the core author has not been formed, and there is less scientific research cooperation between regions.

Objective:To analyze the research status of traditional Chinese Medicine (TCM) constitution identification for hypertension and discuss the research hotspots in this field.Methods:Based on China National Knowledge Infrastructure and Wanfang data knowledge service platform, the papers on TCM constitution identification of hypertension from 2010 to 2021 were retrieved. Bibliometric software Bicomb 2.01 and gCLUTO 1.0 were used to conduct a quantitative study of the retrieved literatures.Results:A total of 836 relevant articles were retrieved, and 42 high-frequency keywords such as "hypertension" "TCM constitution" "TCM constitution identification" and "phlegm-dampness constitution" were screened out. Research hotspots includes hypertension-TCM constitution identification, correlation between hypertension-TCM constitution and risk factors, hypertension-TCM differentiation of body and diet, hypertension-TCM body differentiation and treatment and hypertension-TCM health management.Conclusions:The number of papers on TCM constitution identification for hypertension is increasing year by year, but the regional development is uneven, the core author has not been formed, and there is less scientific research cooperation between regions.

This paper reviews the research status of the training and certification of extracorporeal membrane oxygenation nurses at home and abroad and their job competencies, and analyzes its limitations, so as to provide a reference for the training of extracorporeal membrane oxygenation nurses in my country.

Objective:To establish a competing risk model to predict the cumulative hazard risk probability of the outcomes (unhealed or hyperthyroidism recurrence) of Graves disease (GD) treated with 131I. Methods:From January 2020 to May 2021, 61 GD patients (13 males, 48 females; age (46.0±13.8) years) who received 131I treatment in Zhangzhou Affiliated Hospital of Fujian Medical University were enrolled. The outcomes of treatment were recovery, unhealed or hyperthyroidism recurrence (event 1), and hypothyroidism (event 2). Follow-up was started 1 month after 131I treatment and ended 1 year later. It was terminated in the following conditions: one of the two events occurred; no event occurred after 1 year of follow-up; the research deadline was up. The Fine-Gray test was used to analyze the factors related to event 1, and then the competitive risk model was established. Results:Thirty-nine patients had hypothyroidism, 17 patients were unhealed or had hyperthyroidism recurrence, 2 patients lost follow-up, and 3 patients had normal thyroid function after 1 year follow-up. Multivariate analysis showed that effective half-life (hazard ratio ( HR)=1.74, 95% CI: 1.10-2.75, β=0.55, P=0.019) and thyroid volume ( HR=1.12, 95% CI: 1.07-1.17, β=1.12, P<0.001) were risk factors for event 1, while the elasticity of thyroid was a protective factor ( HR=0.17, 95% CI: 0.06-0.54, β=-1.76, P=0.003). The C index of the nomogram constructed based on the multi-factor competitive risk model was 0.784(95% CI: 0.633-0.935). Conclusions:Thyroid volume, elastic value, and effective half-life are associated with treatment outcomes of 131I. The competitive risk model can predict the therapeutic outcomes of GD patients treated with 131I.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Objective:To explore the diagnostic process and outcomes of patients with aplastic anemia (AA) who received outpatient treatment in a real-world setting.Methods:The diagnostic processes, treatment regimens, and outcomes of 176 patients with AA treated in outpatient centers from January 2018 to December 2019 were reviewed.Results:The median interval from the onset of symptoms to the first visit was 7 (5-120) months. Complaints during the first visit included bleeding (52.3% ) , anemia (51.7% ) , and infection (6.8% ) . For diagnosis, 168 patients (95.5% ) underwent bone marrow aspiration; however, only 22 of them (17.1% ) consented aspiration in multiple sites (sternum) . The completion rate of bone marrow biopsy was 85.1% (143/168) ; flow immunophenotype and karyotype analyses were performed on 59.5% (100/168) and 58.9% (99/168) of AA patients, respectively, and the culture of clonal forming units by bone marrow mononuclear cells was performed on 26.8% (45/168) of AA patients. The most preferred regimen was cyclosporine combined with androgen and levamisole (43.8% , 77 patients) , followed by cyclosporine combined with androgen (25.6% , 45 patients) . Cyclosporine alone was administered in 24 patients (13.6% ) and androgen alone in 16 patients (9.1% ) . Furthermore, 14 patients (7.9% ) did not consent to any drugs or only chose traditional Chinese medicine. The patients were divided according to the frequencies of follow-up: regular follow-up group (≥4 times/year, n=130) and irregular group (<4 times/year, n=46) . The former had a higher 6-month remission rate (52.5% vs 28.0% , P=0.005) , a greater high-quality remission rate in 12 months (40.7% vs 16.7% , P=0.027) , and a lower relapse rate in 24 months (4.4% vs 36.4% , P=0.001) . Conclusion:In real-world settings, bone marrow aspiration in multiple sites should be addressed in outpatient treatment for AA diagnostic work-up, including PNH clone screening, flow immunophenotype, chromosome karyotype analysis, and culture of clonal forming units. Patients with AA who follow regular visits were more likely to achieve high-quality remission and a lower relapse rate. Visits at least four times per year are recommended for AA patients undergoing outpatient treatment.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Group of Pancreatic Surgery, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.