Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To investigate the role of RNA-binding motif protein X-linked(RBMX)in regulating the proliferation,migration,invasion and glycolysis in human bladder cancer cells.Methods A lentivirus vectors system and RNA interference technique were used to construct bladder cancer 1376 and UC-3 cell models with RBMX overexpression and knockdown,respectively,and successful cell modeling was verified using RT-qPCR and Western blotting.Proliferation and colony forming ability of the cells were evaluated using EdU assay and colony-forming assay,and cell migration and invasion abilities were determined using Transwell experiment.The expressions of glycolysis-related proteins M1 pyruvate kinase(PKM1)and M2 pyruvate kinase(PKM2)were detected using Western blotting.The effects of RBMX overexpression and knockdown on glycolysis in the bladder cancer cells were assessed using glucose and lactic acid detection kits.Results RT-qPCR and Western blotting confirmed successful construction of 1376 and UC-3 cell models with RBMX overexpression and knockdown.RBMX overexpression significantly inhibited the proliferation,clone formation,migration and invasion of bladder cancer cells,while RBMX knockdown produced the opposite effects.Western blotting results showed that RBMX overexpression increased the expression of PKM1 and decreased the expression of PKM2,while RBMX knockdown produced the opposite effects.Glucose consumption and lactate production levels were significantly lowered in the cells with RBMX overexpression(P<0.05)but increased significantly following RBMX knockdown(P<0.05).Conclusion RBMX overexpression inhibits bladder cancer progression and lowers glycolysis level in bladder cancer cells by downregulating PKM2 expression,suggesting the potential of RBMX as a molecular target for diagnosis and treatment of bladder cancer.

Objective To explore and implement a differentiated management strategy for multi-campus hospitals to improve patient experience and satisfaction,and achieve the goal of homogenized management.Methods In December 2021,the Picker Patient Experience Questionnaire was used to survey the patient experience at 3 campuses of a tertiary A hospital in Hangzhou,and the reasons for the differences were analyzed.Based on policy document reviews,special group discussions,and expert meetings,differentiated management strategy for multi-campus hospitals was formulated.The patient experience and satisfaction before(December 2021)and after(December 2023)the implementation were compared.Results After the application of the one-hospital multi-campus difference management strategy,the overall medical experience score of the patients in the 3 campus was(58.54±2.36)points,which was higher than(58.13±3.24)points before the application(t=-3.223,P=0.001),and there was no statistically significant differences among the patients in the 3 campuses(F=0.781,P=0.458).After the application of the management strategy,the overall satisfaction score of the patients in the 3 campus was(98.44±6.22)points,which was higher than(97.98±6.87)points before the application of the management strategy(t=-2.490,P=0.013),and there was no statistical significance among the patients in the 3 campus(F=1.128,P=0.324).The number of banners and letters of commendation received by the 3 campuses increased from 1 661 before the application to 2 190 after the application,with a growth rate of 31.85％.Conclusion Differentiated management in a multi-campus hospital,aiming at homogenized quality through differentiated strategies,is practicable and can significantly improve the patient experience and satisfaction across different campuses.

Objective This study aims to develop and validate a dynamic web-based nomogram for predicting kinetophobia in patients following percutaneous coronary intervention(PCI).Methods A prospective design was employed to selectively enroll 330 PCI patients admitted to a hospital in Hangzhou from December 2022 to July 2023.Single-factor analysis and Lasso regression were utilized to identify independent risk factors for kinesophobia post-PCI.Logistic regression was performed using R software,and a nomogram was constructed.The model was assessed through the area under the receiver operating characteristic curve(AUC)and Hosmer-Lemeshow tests.Results There were 206 cases of kinesiophobia in 330 patients after PCI,and the incidence was 62.4％.Logistic regression analysis identified combined heart failure,emergency surgery,NYHA cardiac function grade,ADL level,sedentary behavior,Chinese version of PROMIS Physical Function Summary Table score,and Chinese version of Perceptive Social Support Scale score as independent influencing factors for kinesophobia after PCI(P＜0.05).The AUC value of the model was 0.821,with a sensitivity of 70.4％and specificity of 82.0％.The Hosmer-Lemeshow fit test yielded a non-significant result(x2=9.350,P=0.314).Calibration and decision curves demonstrated the model's favorable calibration and clinical practicability.The C-index of the nomogram prediction model was 0.778,0.774,and 0.800,respectively,by 5-fold cross-validation,10-fold cross-validation,and the Bootstrap method.Conclusion The dynamic nomogram model developed in this study effectively predicts kinesophobia in patients after PCI.It provides valuable references and support for clinical staff in early identification of high-risk patients,enabling the formulation of individualized health education strategies and exercise rehabilitation plans.

To summarize the nursing experience of a child with pulmonary rejection after hematopoietic stem cell transplantation who underwent double lung transplantation and was complicated with bronchiolitis obliterans after lung transplantation and underwent second lung transplantation.The key points of nursing included:the implementation of step-wise lateral position and prone position alternate non-invasive mechanical ventilation to improve lung function;sequential airway clearance was used to control pulmonary infection;precise volume management to prevent pulmonary edema;to strengthen the observation and medication management,prevent hospital infection and rejection;to provide goal-oriented personalized nutritional support to improve nutritional status;psychological nursing measures were implemented to improve the treatment confidence and compliance of children;health education and follow-up management should be strengthened to improve the long-term quality of life.After active treatment and careful nursing,the child recovered and was discharged 26 days after surgery.

Objective:To summarize the characteristics and nursing experience of patients of transthyretin amyloid polyneuropathy.Methods:A retrospective study was performed in 9 patients with transthyretin amyloid polyneuropathy from different area in china from February 2018 to October 2021 in the Second Affiliated Hospital Zhejiang University School of Medical, summarized nursing points:used list to popularize disease knowledge, improved the nursing skills of rare diseases; did a good job in the safety nursing of sensory motor disorders to prevent pressure sores, scalds, fall, thrombosis and other complications, paid attention to the nursing of autonomic nerve dysfunction, prevented postural hypotension. Observe and prevent heart failure, manage diarrhea and constipation, and applied the guide to personalized urinary tract management;provided genetic counseling services, personalized continuing care and psychological care.Results:During hospitalization, the clinical symptoms of 9 patients were improved to varying degrees, after 3 months of telephone follow-up after discharge, 9 patients had no adverse events such as pressure ulcer and fall.Conclusions:By improving specialized skills, predictive risk management and symptom care, the symptoms of postural hypotension, urinary retention, constipation, diarrhea and other symptoms of transthyretin amyloid polyneuropathy patients can be prevented and improved, and adverse events such as falls and pressure sores can be avoided.

Objective:To retrieve and obtain relevant evidence of intra-abdominal pressure-oriented enteral nutrition assessment and management in patients with intra-abdominal hypertension, in order to provide evidence-based evidence for clinical medical staff to make enteral nutrition-related clinical decisions for patients with intra-abdominal hypertension.Methods:Systematic retrieval of Chinese National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature, UpToDate, PubMed, Cochrane Library, BMJ Best Practice and other English data, as well as domestic and foreign guidelines such as American Society for Parenteral and Enteral Nutrition, Scottish Intercollegiate Guidelines Network, etc. All evidence available on the Internet in both Chinese and English on intra-abdominal pressure-guided enteral nutrition strategies in adults with intra-abdominal hypertension, study types including clinical decision-making, systematic reviews/meta-analyses, evidence summaries, expert consensus, guidelines or related to the subject of this study closely related high-quality original research. The retrieval time was from the establishment of the database to November 2021. The literature evaluation tool was selected according to the research type. Two researchers trained in the evidence-based system independently evaluate the quality of the included literature, fully considering the clinical situation and expert opinions, and completed the evidence. Extracted and summarized.Results:Totally 13 articles were finally included, including 5 guidelines, 3 expert consensuses, 1 evidence summary and 4 original studies, and 29 evidence-based practice evidence of enteral nutrition in patients with intra-abdominal hypertension were collected, including the monitoring timing of enteral pressure, the pressure of enteral high pressure and the way of enteral nutrition, the pressure measurement of the abdominal cavity, the setting of abdominal pressure, the temperature conditions for early start of enteral nutrition, the selection of enteral pressure, the temperature setting of enteral nutrition nine aspects such as speed and regulation of internal nutrition and abdominal compartment syndrome prevention.Conclusions:This study summarizes the best evidence of intra-abdominal pressure management and enteral nutrition therapy in patients with intra-abdominal hypertension, and provides evidence-based basis for risk management, standardizing clinical practice, and ensuring treatment safety. In the stage of evidence transformation, clinical medical staff need to comprehensively weigh the benefits and risks of early enteral nutrition, and integrate evidence in combination with clinical practical application scenarios, so as to form a standardized early enteral nutrition management plan suitable for patients with intra-abdominal hypertension.

Objective:To retrieve and summarize the evidence on early enteral nutrition in critically ill patients with prone position ventilation.Methods:The relevant evidence on early enteral nutrition in critically ill patients with prone position ventilation was systematically searched through computer in domestic and foreign guideline websites, institutional websites and databases. The quality was assessed using the literature evaluation criteria and systematic review evaluation tools of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia. The retrieval time limit was from January 1, 2015 to November 11, 2020.Results:A total of 10 articles were included, involving one clinical decision, four guidelines, three systematic reviews, and two original literature. A total of 18 pieces of evidence from 7 aspects were summarized on early enteral nutrition assessment, restart timing, body position, feeding program (intake, transgastric/postpyloric feeding, nasogastric feeding rate, nutritional preparations) , monitoring (gastric residual volume, gastric antral motility index) , drug prevention, staffing and training.Conclusions:This study summarizes the evidence of early enteral nutrition in critically ill patients with prone position ventilation, and provides evidence-based evidence for nursing managers to formulate enteral nutrition plans scientifically.

Objective:To retrieve, appraise and synthesize the best available evidence on prevention and management of incontinence-associated dermatitis in adult inpatients.Methods:All the evidence on prevention and management of incontinence-associated dermatitis in adult inpatients was searched by computer from domestic and foreign electronic databases, guide.com and related professional websites from January 2010 to January 2020. Literature evaluation tools such as AGREEⅡ, AMSTAR were used for evaluation. Data extraction of documents that met the inclusion criteria.Results:A total of 28 pieces of relevant evidence were obtained. It includes 6 aspects: assessment and prevention, management of incontinence, cleaning, moisturizing and protection, treatment, monitoring and management.Conclusions:the 28 pieces of evidences in this study can better guide the medical staff in the prevention and management of incontinence-associated dermatitis in adult inpatients. It is suggested that the medical staff should carefully apply the evidence in combination with the specific clinical environment and the patient ′s will, and pay attention to the update of relevant evidence in time.

Objective:To develop and internally validate a fall related injury risk nomogram in of patients in Patients in hospital.Methods:Patients who fall during the hospital stay from a grade-three general hospital of Zhejiang province were recruited. Data were collected from January 2014 to December 2019. Data was collected after patients fall in hospital, including age, sex, and 18 other predictive factors. The LASSO regression model and multivariable logistic regression analysis were applied to build a predicting model. Discrimination and calibration of the predicting model were assessed using the C-index and calibration plot. Internal validation was assessed using the bootstrapping validation.Results:Of the 243 patients included in the study, 70 patients had fall related injury. The fall related injury probability was 28.81%. Predictors contained in the prediction nomogram included age≥60, dysfunction, combined utilization of special drugs, no-escort, hypocalcemia. The model displayed good discrimination with a C-index of 0.823 (95% confidence interval 0.756-0.875) and good calibration. High C-index value of 0.803 could still be reached in the interval validation.Conclusion:This fall related injury risk nomogram in of patients in Patients in hospital incorporating the age≥60, dysfunction, combined utilization of special drugs, no-escort, hypocalcemia could be conveniently used to predict fall related injury risk of patients in hospital.