Objective:To explore the effect and safety of endoscopic tubular musculoskeletal tumor surgery (ETMS) technology in spinal tumors.Methods:Clinical data were retrospectively collected from 18 spinal tumor patients who were treated with ETMS technology at Tianjin Medical University Cancer Institute and Hospital ( n=16) or the Affiliated Hospital of Qingdao University ( n=2) from November 2022 to December 2023. The total cohort included 11 males and 7 females, with the age at 60.3±8.6 years (range of 41-76). Two cases were diagnosed with benign tumors, four patients were diagnosed with spinal hematologic malignancies while other 12 cases were patients with spinal metastases. After localization under the C-arm X-ray machine, the spinal endoscopic channel is established using dilators. Soft tissue is dissected under endoscopic guidance to create an artificial cavity. Subsequently, the saline medium relied upon by the spinal endoscopic technique is removed, and posterior decompression and tumor curettage are performed using tubular techniques. Frankel grade classification and paraplegia index were used to evaluate the improvement of postoperative function and the VAS score was performed in pain scoring. The surgical complications and tumor evaluation were observed by postoperative outpatient and telephone follow-up. Results:The ETMS technology was successfully completed in all 18 patients with the mean operation time of 240.3±80.2 min. The median of intraoperative bleeding was 200.0(172.5, 350.0) ml and the mean postoperative drainage was 131.4±69.5 ml. The median value of postoperative hospitalization days was 6.0(4.0, 10.25) d. The paraplegia index decreased from 1.5(0, 3.0) preoperatively to 0(0, 1.25) postoperatively ( Z=-2.599, P=0.009). All the patients presented an improvement in Frankel grading after surgery except for one patient (downgrading from grade E to grade D). There was significantly difference in Frankel grading between preoperative and postoperative groups ( Z=2.812, P=0.005). The median value of preoperative VAS score was up to 5.5(4.0, 7.0) while the median value at postoperative, one month after surgery and three months after surgery were 1.5(1.0, 2.25), 1.0(0, 1.0) and 0(0, 1.0), respectively (χ 2=44.641, P<0.001). The 3-month postoperative VAS improvement rate was 91.2% (range 75%-100%). During a mean follow-up period of 7.6±6.2 months, none of the 18 patients presented surgical complications or tumor recurrence at surgical region. Only one patient died at 3.2 months after surgery until the last follow-up due to respiratory failure after lung tumor progression. The mean survival of the total cohort was up to 13.3 [95% CI (11.5, 15.0)] months. The 16 cases with spinal metastases or spinal hematological malignancies had a mean survival of 13.2 [95% CI (11.3, 15.0)] months. Conclusion:The ETMS technology presented good efficacy and safety in treatment of spinal tumors with low blood supply and with diameter less than 5cm.

Objective:To explore the impact of pain, functional disability, self-efficacy and social support on health-related quality of life (HRQOL) in gout patients.Methods:From November 2019 to January 2020, a total of 218 patients with gout were investigated using the general information questionnaire, Visual Analogue Scale, Health Assessment Questionnaire Disability Index, General Self-Efficacy Scale, Perceived Social Support Scale, and Gout Impact Scale. The structural equation model was established by AMOS 24.0 for parth analysis, and the mechanism of pain dysfuction, self-efficacy and social support affecting the quality of life in gout patients was tested.Results:The total score of Gout Impact Scale, pain, functional disability, self-efficacy and social support respectively was 59.94±18.39, 6.00±2.76, 0.25 0, 0.88, 23.39±6.40 and 62.92±8.24. Pain directly influenced HRQOL ( β=-0.293, P<0.01), and indirectly influenced HRQOL ( β=-0.039, P<0.05). Functional disability directly influenced HRQOL ( β=-0.244, P<0.01). Self-efficacy directly influenced HRQOL ( β=0.182, P<0.01), and indirectly influenced HRQOL ( β=0.202, P<0.01) through pain and functional disability. Social support indirectly influenced HRQOL ( β=0.278, P<0.01) through pain, functional disability and self-efficacy. Conclusions:HRQOL of patients among gout is affected by several factors, mainly affected by pain, functional disability and self-efficacy; and there are interactions among them. Targeted interventions should be strengthened to relieve pain, prevent or slow down the progress of physical disability, enhance self-efficacy and social support to improve HRQOL.

Objective:To observe the expression characteristics of small ubiquitin-like modified protein (SUMO) pathway members in osteosarcomaby using molecular biology methods, and provide theoretical basis for targeted therapy based on protein SUMO modification.Methods:Eighteen fresh osteosarcoma tissue samples surgically resected at Tianjin Cancer Hospital from January 2017 to June 2019 were collected. Western blot and immunohistochemical methods were used to detect the protein expressions of SUMO1, SAE1, Ubc9, and SENP1, which are core members of SUMO pathway, in the cancerous and adjacent tissue. Taking osteosarcoma cell line 143B as the research object, three targeted treatment regimens were designed and grouped as follows: control group, nonsense group, siR-SUMO1 group, siR-Ubc9 group, and SENP1 group. Western blot was used to verify the efficiency of gene transfection, the positive expression rate of EdU was detected by cell proliferation detection kit, the ability of cell migration and invasion was measured by scratch test and Transwell invasion test, and the apoptosis rate was detected by flow cytometry. Bone marrow mesenchymal stem cells (BMSCs) were used to evaluate the side effects of three treatment regimens.Results:Results from Western blot and immunohistochemistry showed that the protein expression levels of SUMO1, SAE1, andUbc9 in osteosarcoma tissues were significantly higher than those in adjacent tissues ( P<0.05), but SENP1 was significantly lower than in adjacent tissues. The experimental results based on 143B osteosarcoma cells showed that the siR-SUMO1 group, siR-Ubc9 group, and SENP1 group can significantly inhibit the activation of SUMO pathway in osteosarcoma cells, showing lower tumor cell proliferation ( P<0.05), slower cell migration and invasion capacity ( P<0.05), and higher apoptotic rate ( P<0.05), than the control group and nonsense group; however, experimental results based on BMSCs showed that the siR-SUMO1 group and siR-Ubc9 group can significantly inhibit the proliferation of BMSCs, induce apoptosis, and show great therapeutic side effects, but the SENP1 group has almost no effect on the proliferation and apoptosis of BMSCs ( P>0.05). Conclusion:The SUMO pathway is abnormally activated in osteosarcoma. Exogenous supplementation or endogenous activation of SENP1 is one of the alternatives for targeted osteosarcoma treatment.

Objective Based on lung cancer center database,we analyzed the clinical characteristics of lung patients with bone metastases.The relationship between bone metastases,skeletal-related events,survival time and different pathological subtypes of lung cancer were also evaluated in this study.Methods A total of 861 patients with lung cancer were studied from May 2010 to April 2012 at Tianjin Medical University Cancer Institute and Hospital.As to follow-up situation,patients' survival status and treatment information were collected by telephone follow-up and (or) examinationsin outpatient.The clinical characteristics,skeletal-related events and survival of bone metastaticpatients with different pathological types of lung cancer were analyzed.Logistic regression analysis was used to identify risk factors for bone metastases.The relationship between histological subtypes and the incidence of bone metastases was evaluated using Odds Ratios (ORs).The chi-square test was used to compare the proportion of bone metastases,synchronous bone metastases and SREs among different histological subtypes patients.The overall survivals was evaluated using the Kaplan Meier.Results A total of 861 patients with lung cancerwere enrolled in this study,including 293 cases with bone metastases.The average follow-up of our population was 14.2 months and the last follow-up time was September 2017.Among different pathological types of lung cancer,adenocarcinoma (39.14％,173/442) has the highest incidence of bone metastases,followed by other types (29.91％,35/117),squamous cell carcinoma (29.47％,56/190) and SCLC (25.89％,29/112).Spine (59.73％,175/293) was the most common location site of the bone metastases,followed by the ribs (49.15％,144/293),pelvis (20.48％,60/293),femur (16.38％,48/293) and sternal (16.38％,48/293).Lung adenocarcinoma was a risk factor for bonemetastases (P=0.002).In ORs analyze,adenocarcinoma patients were more likely to develop bone metastases [OR=1.60,95％CI (1.21～2.13)].In our cohort,58.36％of patients with lung cancer had skeletal related events.Among various types of skeletal related events of patients with bone metastases,the most common one was radiotherapy for bone metastases (51.88％,152/293),followed by pathological fractures (15.02％,44/293),spinal cord compression (6.48％,19/293),bone instability requiring surgery (4.78％,14/293) and hypercalcemia (1.71％,5/293).There was no significant difference between different types of skeletal related events.The median survival time of the patients with bone metastases was 11.5 months.There was no significant difference in survival between adenocarcinoma patients and non-adenocarcinoma patients (P=0.111).Conclusion This study suggested that the incidence of bone metastasis in lung adenocarcinoma was 39.14％ and lung adenocarcinoma was a risk factor for bone metastases,which supported early screening and monitoring of bone metastasis in the patients.

Objective? To construct the training content for gerontological advanced practice specialty nurses based on advanced practice nurse (APN) core competence. Methods? From January 2017 to February 2018, the frame of gerontological advanced practice specialty nurses core competence and training content was built preliminarily with the methods of literature review and theoretical analysis. The training content for gerontological advanced practice specialty nurses was confirmed finally by the Delphi method involving 18 expert enquiries. Results? After two rounds of expert consultation, the core competence was established finally including 5 primary indicators and 37 secondary indicators. Besides, the core competence training content included 9 primary indicators and 103 secondary indicators. The authoritative coefficients of experts were greater than 0.80, and the P value of Kendall coordination coefficients test of two rounds of expert consultation were less than 0.05. Conclusions? The results of the Delphi expert's consultation are concentrated, the research results are true and reliable with a certain practical significance. It can provide a reference for the training of gerontological advanced practice specialty nurses, but still need to be tested in practice.

This paper introduces the enhanced recovery after surgery (ERAS) of the definition and concept, elaborates the domestic and foreign research results of ERAS in various fields of evidence-based nursing care in perioperative period, and the future development direction of ERAS are discussed.The purpose of this literature is to provide a reference for the individualized,specialized of the ERAS program for different diseases and different operations.

Objective To construct a core competency-based curriculum for master of geriatric nursing specialist. Methods On the basis of literature review and theoretical analysis,the curriculum for master of geriatric nursing specialist was set up,and through 6 experts'modification with Delphi method,the final entries were confirmed.Results Through two-round consultation,the training course system formaster of geriatric nursing was established to consist of 9 entries and 33 sub-entries.The response coefficients of the two-round consultations were 100%,and the authority coefficients of the experts were 0.86 and 0.92 respectively.The coordination coefficients for overall entries were 0.534 and 0.593 respectively with P<0.001,indicating statistically significant differences. Conclusion The curriculum for master of geriatric nursing is reliable and valid,which can provide practical basis.

Objective: To summarize the clinical data including manifestations, diagnosis, treatment and prognosis of eosinophilic gastroenteritis (EGE) in children. Methods: A retrospective analysis was performed in 71 patients with pathologically proven EGE at Beijing Children's Hospital Affiliated to Capital Medical University from January 2008 to January 2017. Their clinical manifestations, laboratory and imaging examinations, endoscopic findings, histopathological examinations, and treatment were collected and analyzed. Results: Among 71 EGE cases, 47 (66%) cases were male and 24 (34%) cases were female, and the median age was 9.2 (0.2-16.5) years old. The main clinical manifestations included abdominal pain (76%, 54/71), vomiting (68%, 48/71), anorexia (54%, 38/71), weight loss (38%, 27/71), and diarrhea (37%, 26/71). There were 27 cases (38%) with a history of allergic diseases or family history. The median absolute value of eosinophil in peripheral blood of the 71 patients was 0.4 (0-36.8)×10⁹/L, and 27 cases (38%) showed an increase in eosinophil counts. Serum IgE was measured in 52 patients (104.3 (3.4- 3 000.0)×10³ U/L), and 30 patients (58%) showed an increase in serum IgE. A large number of eosinophils ((41.0±8.5)/HP) were found in 3 patients' ascites. The endoscopic examination of upper gastrointestinal tract revealed hyperemic edema in 62 cases (87%), plaque in 44 cases (62%), erosion in 17 cases (24%) and ulceration in 16 cases (23%). Histopathologically, in 8 cases (11%) the disease involved both stomach and duodeneum, in 21 cases (30%) involved stomach only, and in 37 cases (52%) involved duodeneum only. In addition, in 6 cases (8%) the disease involved esophagus and in 10 cases (14%) involved colorectum. Microscopically, eosinophil counts averaged 67/HP, 33/HP, 40/HP and 38/HP in esophageal, gastric, duodenal and colorectal mucosa respectively. A total of 34 cases were treated with glucocorticoid, and all these patients had alleviation of symptoms, which occurred within 14.9 days on average, but EGE recurred in 11 cases (32%). Conclusions The clinical symptoms and endoscopic findings of EGE are diverse and nonspecific. Histopathological examination of gastrointestinal mucosa is particularly important for the diagnosis. Glucocorticoid treatment is effective, but the patients with EGE are prone to relapse.

Objective To investigate the current status of learning burnout on Basic Nursing Science practical course among five-year higher vocational nursing students and to analyze the reasons for burnout from nursing students' perspectives.Methods We selected 285 nursing students in a five-year higher vocational college by convenience sampling. The higher vocational nursing students practical training learning burnout questionnaire was used to investigate them. Among 285 nursing students, a total of 12 of them were selected to carry out focus group interview to explore the reasons for learning burnout of nursing students.Results A total of 285 questionnaires were sent out and 278 valid questionnaires were collected. Among 278 nursing students, the total score of higher vocational nursing students practical training learning burnout questionnaire was (2.78±0.52) with 93.9％ for the detection rate of learning burnout. There were statistical differences in the scores of the learning burnout questionnaire among nursing students with different sexes, places of birth, academic record and whether like nursing specialty (P<0.05).Conclusions The learning burnout of five-year higher vocational nursing students is common in nursing practical training. Many factors lead to practical training learning burnout of nursing students, such as individual, teachers, companions and vocational perspective.

Objective To systematically review the application effects of bundles nursing on pressure ulcer nursing intervention of elderly patients. Methods Clinical control trails of the application effect of bundles nursing on pressure ulcer nursing of elderly patients were searched using computer in cooperation with manual retrieval from SinoMed,VIP,CNKI,and WanFang database. Two reviewers independently searched and extracted data, screened captured citations,and assessed methodological quality of all included studies. RevMan 5.3 software was used for Meta-analysis. Results Twenty-nine literatures were included for systematic review with 3 020 cases. Meta-analysis showed that,bundles nursing significantly increased the effective rate of pressure ulcer treatment of elderly patients [RR=1.26,95%CI (1.22,1.31)],and improved the degree of nursing satisfaction [RR=1.18, 95%CI (1.12,1.25)] when compared with the usual care group. The differences were statistically significant (P< 0.05). Conclusions Bundles nursing can significantly increase the effective rate of pressure ulcer treatment of elderly patients,and improve the nursing satisfaction,so it is worthy of promotion.