Objective:To analyze the risk factors associated with difficult weaning in mechanical ventilation for pediatric patients and investigate the predictive value of utilizing lung ultrasound assessment to optimize preparation for weaning and enhance success rates, thereby establishing a scientific foundation.Methods:A multi-center, prospective observational study, convenience sampling was utilized to select 97 pediatric patients who underwent endotracheal intubation at the Shanghai Children's Medical Center affiliated with Shanghai Jiao Tong University School of Medicine and Fujian Provincial Children's Hospital between September 2022 and May 2023. Lung ultrasound scores (LUS), Pediatric Critical Illness Score (PCIS), indicators related to respiratory oxygenation function and follow-up weaning outcomes were collected within 48-72 hours post-mechanical ventilation and prior to the first spontaneous breathing trial. The predictive efficacy of LUS in conjunction with risk factors associated with weaning difficulty on pediatric weaning outcomes was evaluated independently.Results:Among the 97 children studied, there were 57 boys and 40 girls, with ages ranging from 1 month to 14 years. By following up with weaning outcomes, the pediatric patients were divided into 55 cases of successful weaning group and 42 cases of difficult weaning group. During 48-72 hours of mechanical ventilation, LUS ( OR=2.05, 95% CI 1.43-2.94, P<0.05) and PCIS ( OR=0.68, 95% CI 0.50-0.92, P<0.05) were early risk factors for subsequent difficulties in weaning. And meantime, the combination of LUS(≥20 points) and PCIS(≤72 points) could effectively predict the risk of difficult weaning with a sensitivity of 61.90%, specificity of 96.36%, and an area under curve value of 0.84. Furthermore, before the first spontaneous breathing test, LUS ( OR=4.29, 95% CI 2.36-7.81, P<0.05) and rapid shallow breathing index (RSBI) ( OR=1.84, 95% CI 1.01-3.36, P<0.05) were identified as risk factors for pediatric difficult weaning, and their combination LUS (≥16 points) and RSBI (>6.4) could predict the risk of difficult weaning more accurately with a sensitivity of 76.19%, specificity of 90.91%, and an area under curve value of 0.92. Conclusions:The application of pediatric ICU specialist nurses, based on bedside LUS combined with PCIS and RSBI, can effectively assess and identify the risk of children with difficult weaning in the early stage, and identify the risk factors, providing a scientific basis for implementing individualized pulmonary rehabilitation nursing and helping children successfully weaning.

Objective:To explore the clinical effect of predictive airway nursing model in mechanically ventilated children after liver transplantation.Methods:Using a before-and-after comparison study, we selected 76 cases of mechanically ventilated children undergoing pediatric living donor liver transplantation in Pediatric Intensive Care Unit from January 2016 to December 2019 at Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine. The children were divided into the control group (35 cases) and the intervention group (41 cases) in chronological order. The control group implemented conventional airway nursing, and the intervention group conducted predictive airway nursing. The hospitalization days, mechanical ventilation time, ventilator-associated pneumonia (VAP) incidence, ventilator removal ending and other indicators were compared between the two groups.Results:There was no statistically significant difference in the total incidence of secondary infection between the intervention group and the control group ( P>0.05) . The time of mechanical ventilation were shorter than that in the control group, and the differences were statistically significant ( P<0.05) . The intervention group was better than the control group in successfully removing the ventilator, and the difference was statistically significant ( P<0.05) . Conclusions:The predictive airway nursing model can shorten the time of mechanied ventilation in children after liver transplantation and increase the success rate of removing the ventilator, it can be used for clinical reference.

Objective:To explore the relationship between anxiety, depression and various dimensions of cognitive function in patients with mild cognitive impairment (MCI) .Methods:The convenient sampling method was adopted to conduct memory screening for 727 elderly people who visited the multidisciplinary joint memory clinic of a Class Ⅲ Grade A hospital in Beijing from January to December 2019. With their consent, 247 MCI patients were investigated using Montreal Cognitive Assessment (MoCA) , Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) .Results:A total of 247 questionnaires were distributed and 233 valid questionnaires were returned. There were 67 cases (28.8%) of MCI patients with anxiety and depression, 11 cases (4.7%) with anxiety, 53 cases (22.7%) with depression and 102 cases (43.8%) without anxiety and depression. In MCI patients, anxiety was positively correlated with delayed recall ( P<0.05) , while depression was negatively correlated with language function ( P<0.05) . MCI patients with different emotional states had statistically significant differences in language function ( P<0.05) . Conclusions:MCI patients have a higher incidence of anxiety and depression, and anxiety and depression will affect different dimensions of cognitive function in MCI patients. Medical staff need to provide targeted interventions for MCI patients with different emotional characteristics.

With the global population aging trend, China has entered the aging society in advance and is about to enter the old aging stage in the future, which means many problems will face more severe challenges, such as medical resources tension and difficult to achieve medical treatment. With increasing discussion of disease development and quality of life, hospice palliative care and hospice care are respected. As a health intervention, advance care planning has been developed rapidly in foreign countries. Under the support of the legislation, the advance directive has played a positive role in relieving the shortage of medical resources and improving the quality of life of patients. Domestic scholars have also made a preliminary study on advance care planning.

Objective To develop an evaluation questionaire for assessing the usage of specialist nurses, and to provide a basis for the use and management of specialist nurses.Methods On the basis of reviewing the literature, combined with Delphi method and pre-investigation to form the prediction questionaire, the formal questionaire was finally determined by large sample survey.Results The exploratory factor analysis was used to construct a 5-dimension, 37-item evaluation tool. The reliability Cronbach's α coefficient was 0.964, and the split-half reliability was 0.743, with a test-retest reliability of 0.936, which had good reliability and validity.Conclusions The evaluation tool has a good scientific and practicability, which provides a basis for the management department to understand the status of the work of specialist nurses,and it is conducive to be a better management of specialist nurses with a greater role.

Objective To construct a recombinant adenovirus vector ( Ad-hIL-17F) expressing human interleukin 17F (hIL-17F) and to investigate the effects of expressed hIL-17F on angiogenesis. Methods The hIL-17F fragments was amplified by PCR using pUCm-T/hIL-17F plasmids as templates and then cloned into pAdTrack-CMV transfer vector to form pAdTrack-CMV-hIL-17F.The pAdTrack-CMV-hIL-17F transfer vector was linearized with PmeI digestion and then transformed into competent BJ 5183 with pAdEasy-1 backbone vector for homologous recombination .Then it was linearized with PacI digestion and transfected into human embryonic kidney 293 (QBI-293A) cells to construct Ad-hIL-17F.RT-PCR analysis and indirect immunofluorescent assay (IFA) were performed to determine the expressions of hIL-17F.MTT assay was used to detect the inhibitory effects on cell growth of ECV 304 .The expressions of VEGF and Ang-1 in 293 A and ECV304 cells were measured by ELISA .The effects of Ad-hIL-17 F on the expressions of VEGF in 293A cells were analyzed by Real-Time PCR.Results The sequencing result verified that hIL-17F gene fragment was correctly inserted in the vector .The expressions of hIL-17F gene at mRNA and pro-tein levels were confirmed by RT-PCR and IFA.Ad-hIL-17F could significantly inhibit the growth of ECV304 cells and down-regulate the expressions of VEGF and Ang-1 in 293A and ECV304 cells.Conclu-sion Ad-hIL17F expressing hIL-17F was successfully constructed .The expressed hIL-17F could inhibit the angiogenesis through down-regulating the expressions of VEGF and Ang-1.

Objective To analyze the distribution and evolution of the risk factors for coronary heart disease (CHD) in middle-aging males, and provide the evidence for the prevention and treatment of male patients with CHD. Methods 1639 male people over 45 years old were enrolled in the study. They were divided into non- senile group (45-59 years old) and senile group (60-93 years old).The subjects over 60 years old were further divided into three groups:60-69 years old group, 70-79 years old group, 80-93 years old group. The interrelation between the risk factors of CHD and aging was analyzed. Results The prevalence rates of drinking, smoking, diastolic hypertension and low HDL-C in non-senile group were much higher than those in senile group (x2=28.80,18.35,15.72,17.84,P<0.01). In contrast, the prevalence rates of overweight, systolic hypertension, fasting hyperglycemia,postprandial hyperglycemia in senile group were significantly higher than those in non senile group. The prevalence rates of high triglyceride in non- senile group and senile group were 18.0% and 16.2% respectively(P>0.05). The prevalence rates of high cholesterol in non- senile group and senile group were 36.9% and 31.5% respectively(P>0.05). There was a significant decrease in the prevalence rates of overweight, postprandial hyperglycemia (P<0.05) and drinking,smoking, diastolic hypertension, high triglyeeride (P<0.01) in over 70-year+old males. And the prevalence rates of overweight, postprandial hyperglycemia, high triglyceride of over 80-year-old males were higher than those of over 70-year-old males (x2=10.05,4.16,5.97,P＜0.01). However,the prevalence rates of systolic hypertension of over 80-year-old males were lower than those of over 70-year-old males (X2=21.25,P＜0.01). There was no significant change in other risk factors of CHD at different ages of senile group. Conclusions For non-senile males, the important measures to treat the risk factors of CHD should include stopping smoking, restricting alcohol, eating low fat diet, changing bad life habits, controlling diastolic hypertension and modifying lipid. In contrast, for senile males, more attention should he paid to limiting total energy intake, increasing sports, losing weight, controlling systolic hypertension, hyperglycemia and modifying lipid.

Objective To evaluate the effect of health education on the old male patients with primary hypertension.Methods 120 old male patients with primary hypertension were randomly selected from the whole group and educated with health knowledge related to blood hypertension, and the changes of life style and blood pressure after health education were recorded.Results Most of the patients changed their unhealthy life style. Among these patients, more than 80% were able to have a stable emotion, regular daily life, stop smoking and less drinking, there were 66% cases with a healthy diet. The systolic pressure of the patients declined significantly after health education (P<0.01).Conclusion The health education is an efficient way to control hypertension in the official-service outpatient department.

Objective To investigate the factors related to the depression in the retired old army officers in Beijing, to establish effective nursing intervention on these factors. Methods Various factors related to depression were investigate using questionnaire in 500 retired army officers. Results Among 500 subjects, 23.0% (115/500) were with minor depression, 6.4% (32/500) with moderate depression, while 1.6% with severe depression. Subjects whose wife were still alive had much less incurrence rate of depression than ones remarried or widowed. The less time after retirement and less satisfaction in life were other important factors related to depression. Conclusion Psychological care should be emphasized on widowed, freshly retired, or people feeling less satisfactory in life. Active nursing intervention should be applied to lower the harmful effect of depression on health.

ObjectiveTo investigate the anxiety and its interrelated factors of elderly outpatients. MethodsZung self-rating anxiety scale was used to evaluate 971 elderly outpatients, the scores between different sex, age, degree of education, etc. were compared. ResultsThe scores may become significantly different with the patients' sex, age, degree of education, satisfaction in regards to medical service and recognition of the disease(P<0.05).ConclusionFactors such as sex, age, degree of education, satisfaction of medical service, etc, deeply affect the anxiety in elderly outpatients.