Objective To analyze the consistency between computer tomography angiography(CTA)and digital subtraction angiography(DSA)in evaluating the global limb anatomic staging system(GLASS)stage of patients with chronic limb-threatening ischemia(CLTI).Methods The clinical data of patients with CLTI,who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University of China to receive treatment between January 2017 and December 2020,were retrospectively analyzed.Taking the DSA assessment as the gold standard,the consistency of CTA and DSA in evaluating the GLASS stage of patients with CLTI was analyzed.Results In the assessment of GLASS stage of CLTI,CTA showed strong agreement with DSA.The weighted Kappa coefficient of CTA and DSA for the staging of femoropopliteal segment was 0.798(95％CI=0.722-0.873,P＜0.01),and the weighted Kappa coefficient of CTA and DSA for the staging of infrapopliteal artery segment was 0.785(95％ CI=0.725-0.845,P＜0.0l).For the overall staging of GLASS,the weighted Kappa coefficient of CTA and DSA was 0.832(95％ CI=0.752-0.91 1,P＜0.01).All the above results indicated that a very strong consistency existed between CTA and DSA in evaluating the GLASS stage of patients with CLTI.Conclusion CTA examination of lower limb can accurately evaluate GLASS score and stage of CLTI patient's target lesions,which is helpful in diagnosing lower extremity arteriosclerosis occlusion disease as well as in assessing the technical difficulty degree of its revascularization operation.(J Intervent Radiol,2024,33:300-303)

Objective:To retrieve, assess and summarize the best evidence for prevention and management of totally implantable venous access port blockage in malignant tumor patients.Methods:Literatures related to the prevention and management of infusion port blockage were searched by computer on BMJ Best Practice, UpToDate, Australian Joanna Briggs Institute Evidence-Based Health Care Centre Database, Guidelines International Network, National Guideline Clearinghouse, Cochrane Library, Ovid, PubMed, CNKI, Wanfang Database, VIP, Medlive, China Biomedical Medline Disc and other Chinese and English databases. The search period was from January 2013 to January 2023. Two researchers evaluated the quality of the literatures respectively, and the literatures that met the criteria were extracted, integrated and graded.Results:A total of 18 literatures were included, including 2 guidelines, 9 evidence summaries, 5 expert consensus articles and 2 systematic reviews. A total of 34 pieces of evidence were summarized from 6 aspects, including personnel training, nursing evaluation, catheter implantation, catheter maintenance, blockage management and health education.Conclusions:Summary of the best evidence for prevention and management of totally implantable venous access port blockage is comprehensive. Clinical medical staff should apply the evidence according to the medical situation to reduce the occurrence of blockage of infusion port.

Objective:To develop a risk assessment scale for infusion port occlusion in patients with malignant tumors and to test its reliability and validity.Methods:An initial item pool was constructed based on literature review. Through purposive sampling, two rounds of Delphi consultations with 20 experts were conducted from March to May 2023. Weights were assigned to the indicators using the analytic hierarchy process (AHP), and the risk assessment scale was finalized. From June to September 2023, a convenience sample of 278 malignant tumor patients with infusion ports from four Class Ⅲ Grade A hospitals in Shanxi Province was selected for item analysis and reliability and validity testing.Results:The risk assessment scale for infusion port occlusion in malignant tumor patients includes five dimensions, 16 primary indicators, and 35 secondary indicators. The content validity index at the scale level was 0.925, and at the item level ranged from 0.818 to 1.000. A total of five factors were extracted by exploratory factor analysis, with a cumulative contribution rate of 57.081% to the variance. The area under the receiver operating characteristic curve was 0.815, with a cutoff score of 24.50. The overall Cronbach's α coefficient was 0.910, and the split-half reliability coefficient was 0.762.Conclusions:The risk assessment scale for infusion port occlusion in malignant tumor patients demonstrates good reliability and validity, and has high predictive power, which provides a scientific basis for identifying high-risk populations in clinical settings.

Objective:Based on cognitive behavioral therapy, to construct a physical and mental adjustment intervention plan for the main caregiver of cancer patients through the network platform.Methods:Through evidence-based literature published from July 2012 to July 2022 screening and evaluation, combined with qualitative interviews for 10 primary caregivers of cancer patients, the intervention plan for physical and mental adjustment of the main caregivers of cancer patients was preliminarily formulated. After consultation with Delphi experts (15 cases) through two rounds, the intervention plan was finally determined.Results:In the two rounds of expert letter inquiries, 15 questionnaires were distributed and 15 valid questionnaires were recovered. The effective recovery rate was 100.00% and the expert authority coefficient were 0.89 and 0.90 in the two rounds of expert letter inquiries respectively, the Kendall harmony coefficients were 0.279 and 0.323 respectively, and the differences were all statistically significant ( P<0.01). The intervention plan for physical and mental adjustment ofthe main caregivers of cancer patients included 5 first-level indicators (basic knowledge, symptom education, home care knowledge, relaxation training, social support), 27 second-level indicatorsand 54 third-level indicators. Conclusions:The method of the psychosomatic regulation intervention program is scientific and practical, which can be initially applied to the psychological adjustment of the main caregivers of cancer patients, so as to provide a reference for improving their negative emotions.

Objective:To explore the effect of intelligent psychosomatic intervention based on cognitive behavior therapy on pain, fatigue, sleep disorder symptom cluster and negative mood of patients with advanced cancer.Methods:From September to December 2021, 77 patients with intermediate and terminal cancer hospitalized in the Oncology Department of a Class Ⅲ Grade A hospital in Shanxi Province were selected as the study subject by convenient sampling. The patients were divided into control group ( n=39) and test group ( n=38) according to the wards. The control group received routine nursing of tumor diseases, while the test group received intelligent psychosomatic intervention on the basis of routine nursing. The Chinese version of Chinese Version of Brief Pain Inventory (BPI-C) , Chinese Version of Brief Fatigue Inventory (BFI-C) , Pittsburgh Sleep Quality Index (PSQI) , 7 item Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate the effects of the two groups before and after intervention. Results:After intervention, there was no statistical difference in pain scores between the two groups ( P>0.05) , but the pain scores of patients in the test group decreased after intervention compared with those before intervention, with a statistical difference ( P<0.05) . After the intervention, the fatigue scores of patients in both groups decreased, with a statistically significant difference compared with that before the intervention ( P<0.05) , and after the intervention, the fatigue scores in the test group were lower than those in the control group, with a statistically significant difference ( P<0.05) . After intervention, the scores of sleep, anxiety and depression in the test group were lower than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:The intelligent symptom cluster management for patients with advanced cancer has preliminarily proved that it has certain effects on pain, fatigue, sleep disorder symptom clusters and psychological and emotional problems of patients, and is worthy of further research and promotion.

Objective:To explore the effect of enhanced recovery after surgery model based on muti-disciplinary team in patients with interstitial cystitis.Methods:From January 2018 to December 2021, a total of 90 patients with interstitial cystitis in Urology Department of Beijing Chaoyang Hospital, Capital Medical University were selected as the research objects using the convenience sampling method, 44 patients from January 2018 to June 2019 were enrolled as the control group, 46 patients from July 2019 to December 2021 were enrolled as the observation group. The control group received traditional perioperative care model, and the observation group conducted enhanced recovery after surgery model based on multidisciplinary collaboration. The postoperative recovery status and scores of Visual Analogue Scale, Hamilton Anxiety Inventory (HAMA), Hamilton Depression Inventory (HAMD), General Quality of Life Questionnaire-74 (GQOL-74) and nursing satisfaction were compared between the two groups.Results:The time of postoperative first venting, feeding and postoperative hospitalization of the observation group were shorter than those of the control group, and the number of patients with postoperative gastrointestinal reaction was less than that of the control group, and the differences were statistically significant ( P<0.05). One, three day after surgery and at discharge, the scores of Visual Analogue Scale of the observation group were lower than that of the control group, and the differences were statistically significant ( P<0.05). At discharge, the scores of HAMA and HAMD of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05). At discharge, the scores of mental function, physical function, material life, social function and nursing satisfaction of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Enhanced recovery after surgery model based on muti-disciplinary team can reduce the negative emotions of patients with interstitial cystitis, shorten the length of hospital stay, improve nursing satisfaction and patients' quality of life, which is worthy of clinical application.

Objective:To explore the effect of computerized cognitive behavioral therapy on perioperative psychosomatic symptoms in patients with gastric cancer.Methods:Using the convenience sampling method, a total of 76 gastric cancer patients who were scheduled to undergo surgical treatment in Gastrointestinal Department of First Hospital of Shanxi Medical University from September 2021 to March 2022 were selected as the research objects. A total of 38 patients admitted from September to December 2021 were set as test group, while 38 patients admitted from January to March 2022 were set as control group. The control group was given routine nursing measures, while the test group was given psychosomatic intervention program of computerized cognitive behavioral therapy based on routine nursing measures. The effects of the intervention were evaluated using Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Visual Analogue Scale (VAS) and Athens Insomnia Scale (AIS). The first time to get out of bed, first postoperative exhaust time and the postoperative length of hospital stay were compared between the two groups.Results:After intervention, the SAS, SDS and AIS score of the test group was lower than that of the control group, and the difference was statistically significant ( P<0.05). VAS score of the test group was lower than that of the control group at different time points after surgery, and the difference was statistically significant ( P<0.05). The first time to get out of bed, the first time to exhaust gas and the postoperative hospital stay in the test group were shorter than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The implementation of computerized cognitive behavioral therapy can effectively improve perioperative psychosomatic symptoms of gastric cancer patients and the postoperative recovery process.

Objective:To investigate changes in circadian gene cryptochrome 2 (CRY2) expression in mouse models of psoriasis and HaCaT cells, and to explore underlying mechanisms.Methods:Imiquimod-induced mouse model experiment: 12 C57BL/6 female mice were randomly and equally divided into imiquimod group receiving topical imiquimod treatment for 5 consecutive days and control group receiving no treatment; these mice were sacrificed on day 6, skin tissues were resected from the back of mice, and immunofluorescence staining was performed to determine the CRY2 expression in the epidermis. HaCaT cell transfection experiment: HaCaT cells with small interfering RNA (siRNA) -mediated knockdown of CRY2 served as siRNA-CRY2 group, and siRNA-NC group as control group; 5-ethynyl-2′-deoxyuridine (EdU) staining was performed to evaluate the proliferative activity of the HaCaT cells, real-time fluorescence-based quantitative PCR (qPCR) to determine the mRNA expression of chemokines in the HaCaT cells, and Western blot analysis to determine phosphorylation levels of extracellular signal-regulated kinase 1/2 (ERK1/2) . Tumor necrosis factor-α (TNF-α) -stimulated animal and cell experiments: 12 C57BL/6 female mice were randomly and equally divided into TNF-α group subcutaneously injected with TNF-α solution in the ear for 6 days, and phosphate buffered saline (PBS) group subcutaneously injected with the same amount of PBS; the mice were sacrificed on day 7, skin tissues were resected from the ear of mice, and immunofluorescence staining was conducted to determine the CRY2 expression in the epidermis; CRY2-knockdown HaCaT cells stimulated with 50 ng/ml TNF-α for 12 hours served as siRNA-CRY2 + TNF-α group, and siRNA-NC + TNF-α group as control group; qPCR was performed to determine the mRNA expression of chemokines in HaCaT cells in the above groups. Statistical analysis was carried out by using two-independent-sample t test. Results:Immunofluorescence staining showed that the CRY2 protein expression was significantly lower in the mouse dorsal epidermis in the imiquimod group (0.94 ± 0.23) than in the control group (2.30 ± 0.25, t = 3.99, P = 0.016) . Compared with the siRNA-NC group, the siRNA-CRY2 group showed significantly increased proportions of EdU-positive cells (48.13% ± 10.97% vs. 38.23% ± 0.81%, t = 5.00, P = 0.007) , mRNA expression levels of chemokines CXCL1 and CXCL8, as well as significantly increased phosphorylated (p) -ERK1/2 protein expression levels (all P < 0.05) , while there were no significant differences in the CCL20 mRNA expression or ERK1/2 protein expression between the two groups (both P > 0.05) . Immunofluorescence staining showed significantly decreased CRY2 protein expression level in the mouse ear epidermis in the TNF-α group (0.37 ± 0.34) compared with the PBS group (2.04 ± 0.17, t = 4.38, P = 0.012) ; the relative mRNA expression levels of chemokines CXCL1, CXCL8, and CCL20 in HaCaT cells were significantly higher in the siRNA-CRY2 + TNF-α group than in the siRNA-NC + TNF-α group (all P < 0.05) . Conclusion:CRY2 was markedly underexpressed in psoriasis, which might promote the proliferation of keratinocytes and expression of chemokines CXCL1, CXCL8 and CCL20, and TNF-α might be an upstream cytokine that could downregulate CRY2 expression.

This paper reviews the concepts, classifications and application of intelligent cognitive behavioral therapy in the symptom management of cancer patients, and points out the shortcomings and prospects, so as to provide a reference for intelligent intervention and related research in the symptom management of cancer patients.

Objective:To understand the etiology and clinical characteristics of hospitalized severe community-acquired pneumonia(SCAP) in Changchun, and provide scientific basis for its etiology diagnosis and targeted treatment.Methods:The study subjects included 618 children with clinical diagnosis of SCAP who were hospitalized from January 2016 to December 2019.We collected pharyngeal swabs and alveolar lavage fluid from children.Virus isolation, bacterial culture, time-of-flight mass spectrometry, PCR/RT-PCR, colloidal gold method and Optochin test were used to detect the antigen, nucleic acid and protein profiles in the specimen.Results:There were more boys than girls in hospitalized children with SCAP.The peak age of onset was 7 to 12 months.Most cases occurred in winter and spring.The highest detection rate of SCAP virus was 56.15%(347/618); 73.49%(255/347) were positive for one virus, among which the top five were respiratory syncytial virus (27.8%), influenza A virus (23.9%), influenza B virus (16.1%), rhinovirus (12.2%) and metapneumovirus (10.2%). Two viruses were positive for 19.88%(69/347); three viruses were positive for 4.32%(15/347); four viruses were positive for 2.31%(8/347). Atypical microbial infections were 29.77%(184/618), of which Mycoplasma pneumoniae accounted for 95.65%(176/184). Bacterial infections were 17.31%(107/618), mainly Streptococcus pneumoniae(39.25%, 42/107) and Staphylococcus aureus(24.30%, 26/107). The mixed infection of multiple pathogens was 7.61%(47/618), among which the mixed infection rates of Mycoplasma pneumonia with Streptococcus pneumoniae, virus were 40.43% and 34.04%, respectively.High fever, faster breathing, and perioral cyanosis were risk factors for SCAP, with OR and 95% CI of 7.71 and 4.56-13.04, 2.43 and 2.02-2.93, 3.53 and 2.56-4.86, respectively.Viral co-infection occurred in 36.96%(34/92) of complications such as heart failure, toxic encephalopathy, and myocardial damage; Mycoplasma pneumoniae and other pathogens co-infected 35.29% of children with pleural effusion. Conclusion:The pathogens of SCAP in Changchun are mainly viruses notably, respiratory syncytial virus is the dominant pathogen, followed by Mycoplasma pneumoniae.The bacterial pathogen is mainly Streptococcus pneumoniae.High fever, faster breathing, and cyanosis around the mouth are risk factors for severe pneumonia.Multi-pathogen mixed infection is prone to serious complications.