Objective:To systematically evaluate the risk prediction model of ICU-acquired dysphagia in critically ill patients, and to provide a reference basis for medical practitioners to select or develop suitable risk assessment tools.Methods:Cross-sectional studies, case-control studies, and cohort studies of ICU-acquired dysphagia risk prediction models were searched in eight databases, including Wanfang database, China Biomedical Literature Database, VIP database, China National Knowledge Infrastructure, PubMed, Embase, CINAHL, and the Cochrane Library in both English and Chinese, and the search timeframe was from the construction of the database to July 5th, 2023. and the search was limited to Chinese and English. Literature was independently screened and data were extracted by 2 investigators, and the risk of bias assessment tool for predictive modeling studies was applied to analyze the risk of bias and applicability of the included literature.Results:A total of 8 high-quality papers were included, including 8 predictive models of risk of ICU-acquired dysphagia. The area under the subject operating characteristic curve for the models ranged from 0.750 to 0.980, with 6 models reporting calibration and 2 models having a Hosmer-Lemeshow test P>0.05, indicating good agreement. 2 models were externally validated. Independent predictors reported repeatedly for multivariate models were age ≥ 65 years, chronic lung disease, cerebrovascular disease, comorbid arrhythmias, use of sedative medications and duration of use, Acute Physiology and Chronic Health Evaluation Ⅱ score ≥ 15, presence of a nasogastric tube, duration of indwelling gastric tube ≥ 72 h, and duration of endotracheal intubation ≥ 72 h. Smaller sample sizes (outcome events), insufficient attention to missing data, variable screening processes irrationality, and model overfitting increased the risk of model bias. Conclusions:The included models showed overall good discrimination and applicability, but their risk of bias was high, and external validation was carried out in only a very few studies. Future studies should refer to transparent reports of multivariate predictive models to develop, update, and validate the models to obtain high-quality predictive models of the risk of ICU-acquired dysphagia, which can provide a reference basis for the development of relevant preventive strategies.

Objective To investigate current situations of emotional labour,career success and psychological resilience among the nurses and to explore the mediating role of psychological resilience between emotional labour and career success,hence to provide a reference in improvement of the sense of career success among the nurses.Methods Convenience sampling was used to select 922 clinical nurses from 15 Gade ⅡA hospitals in Hubei Province between June and July 2021.A general information questionnaire,the emotional labour scale,career success scale,and psychological resilience scale were used in the investigation.Pearson correlation was employed to analyse the correlations between emotional labour,career success and psychological resilience scores.Amos software was used to construct structural equation model to analyse the mediating effect.Results A total of 842 clinical nurses completed the survey.The total scores of career success and mental resilience of clinical nurses were(73.56±15.55)scores and(62.50±17.12)scores,respectively.In emotional labor,the surface acting dimension score was(20.46±5.92)scores.The score of deep acting dimension was(11.05±2.62),and the score of true emotion expression dimension was(11.95±3.48).Perceived career success was positively correlated with psychological resilience(r=0.593,P<0.001)Career success was negatively correlated with surface acting(r=-0.507,P<0.001).Career success was positively correlated with true emotional expression(r=0.481,P<0.001),and was positively correlated with deep acting(r=0.462,P<0.001).Psychological resilience was negatively correlated with surface acting(r=-0.452,P<0.001),positively correlated with true emotion expression(r=0.402,P<0.001),and positively correlated with deep acting(r=0.392,P<0.001).Psychological resilience plays a partial mediating role between the dimensions of emotional labor(surface acting,true emotional expression,deep acting)and career success,and the mediating effect is-0.146,0.108 and 0.112,accounting for 38.02%,32.05%and 37.21%of the total effect,respectively.Conclusion The three mensions of the emotional labor are at middle level and career success of clinical nurses is above the average level,but the psychological resilience is at a low level.In emotional labor,surface acting can directly negatively affect the ca reer success of clinical nurses,real emotion expression and deep acting can directly positively affect the career success of clinical nurses,and indirectly affect the career success of clinical nurses through the mediating effect of psychological resilience.Nursing managers should pay attention to the management of nurses'emotional labor,improve the level of psychological resilience,and then increase their sense of career success.

Objective To investigate the effect and mechanism of Zhike Pingchuan Formula on reducing airway inflammation in mice with bronchial asthma(BA).Methods A total of 84 BALB/c mice were randomly separated into the control group,the BA group,the low-dose Zhike Pingchuan Formula group,the high-dose Zhike Pingchuan Formula group,the dexamethasone group,the lipopolysaccharide(LPS)group and the high-dose Zhike Pingchuan Formula+LPS group,with 12 mice in each group.The BA model was constructed in all groups of mice except the control group.After successful modeling,mice were treated with drug administration once a day for 3 weeks.Serum immunoglobulin E(IgE)concentration and levels of interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in alveolar lavage fluid were detected by enzyme linked immunosorbent assay(ELISA).Pathological changes in lung tissue was detected by HE staining.The bronchial epithelium goblet cell proliferation and mucus secretion were determined by PAS staining.Flow cytometry was used to detect levels of T helper cell 17(Th17)and regulatory T(Treg)cell in mouse spleen tissue.Western blot assay was used to detect toll-like receptor 4(TLR4)/tumor necrosis factor receptor-associated factor 6(TRAF6)/nuclear factor kappa-B(NF-κB)pathway-related protein expression in lung tissue.Results Compared with the control group,damage of lung tissue was serious,the proliferation of bronchial epithelial goblet cells and the secretion of mucus increased,IgE concentration,TNF-α,IL-17 levels,Th17 cell proportion,Th17/Treg ratio,and TLR4,TRAF6,p-NF-κB p65 protein expression increased,while Treg cell proportion decreased in the BA group(P＜0.05).Compared with the BA group,the bronchial epithelial cupular cell proliferation and mucus secretion were reduced in the low-dose Zhike Pingchuan Formula group,the high-dose Zhike Pingchuan Formula group and the dexamethasone group,the lung tissue damage was improved,the concentration of IgE,levels of TNF-α,IL-17,the proportion of Th17 cells,the ratio of Th17/Treg and expression of protein levels of TLR4,TRAF6 and p-NF-κB p65 were reduced,and the proportion of Treg cell was elevated(P＜0.05).The trend of corresponding indexes in the LPS group was opposite to the above(P＜0.05).Compared with the high-dose Zhike Pingchuan Formula group,the pathological damage of lung tissue increased in the high-dose Zhike Pingchuan Formula+LPS group.The proliferation of bronchial epithelial goblet cells and the secretion of mucus increased,the IgE concentration,TNF-α,IL-17 levels,Th17 cell proportion,Th17/Treg ratio and TLR4,TRAF6,p-NF-κB p65 protein expression increased,while the Treg cell proportion decreased(P＜0.05).Conclusion Zhike Pingchuan Formula may reduce airway inflammation in BA mice by inhibiting TLR4/TRAF6/NF-κB pathway.

Objective To explore the effect of ephedrine on airway remodeling and its regulation effect on transfor-ming growth factor-β1(TGF-β1)/Smads pathway in asthmatic mice.Methods All mice were randomly separated into control group,model group,dexamethasone group,ephedrine low-dose group,ephedrine high-dose group,and ephedrine high-dose+TGF-β1 activator group,with 12 mice in each group.Except for the control group,mice in other groups were intraperitoneally injected with 40 μg ovalbumin(OVA)and 2 mg 10％aluminium hydroxide sensitizer to induce asthma models.After 8 weeks,the airway hyperresponsiveness of mice in each group was detec-ted;eosinophils in bronchoalveolar lavage fluid(BALF)were counted;ELISA was applied to detect the levels of interleukin(IL)-4,IL-5,and IL-13 in BALF;hematoxylin-eosin(HE)staining and Masson staining were applied to observe the pathological changes and collagen fiber area of mouse lung tissue;immunohistochemistry was applied to detect the expression of α-smooth muscle actin(α-SMA)protein in mouse lung tissue;Western blot was applied to detect the expression of TGF-β1/Smads pathway related proteins in mouse lung tissue.Results Compared with the control group,the airway hyperreactivity at different doses of methacholine,total area of airway wall(Wat)/perimeter of the basement membrane(Pbm)ratio,collagen fiber area,eosinophil,the contents of IL-4,IL-5,IL-13,the expression of α-SMA,TGF-β1,the ratios of p-Smad2/Smad2 and p-Smad3/Smad3 in the model group in-creased(P＜0.05),the expression of Smad7 decreased(P＜0.05);compared with the model group,the airway hyperreactivity at different doses of methacholine,Wat/Pbm ratio,collagen fiber area,eosinophil,the contents of IL-4,IL-5,IL-13,the expression of α-SMA,TGF-β1,the ratios of p-Smad2/Smad2 and p-Smad3/Smad3 in the dexamethasone group,the ephedrine low-dose and high-dose groups decreased(P＜0.05),the expression of Smad7 increased(P＜0.05);compared with the ephedrine high-dose group,the airway hyperreactivity at different doses of methacholine,Wat/Pbm ratio,collagen fiber area,eosinophil,the contents of IL-4,IL-5,IL-13,the ex-pression of α-SMA,TGF-β1,the ratios of p-Smad2/Smad2 and p-Smad3/Smad3 in the ephedrine high-dose+TGF-β1 activator group increased(P＜0.05),the expression of Smad7 decreased(P＜0.05).Conclusion E-phedrine can improve airway remodeling in asthmatic mice,and its mechanism is related to the regulation of TGF-β1/Smads signaling pathway.

Objective:To analyze the clinical characteristics and prognosis of patients with infant acute lymphoblastic leukemia (IALL).Methods:A retrospective cohort study.Clinical data, treatment and prognosis of 28 cases of IALL who have been treated at Beijing Children′s Hospital, Capital Medical University and Baoding Children′s Hospital from October 2013 to May 2023 were analyzed retrospectively. Based on the results of fluorescence in situ hybridization (FISH), all patients were divided into KMT2A gene rearrangement (KMT2A-R) positive group and KMT2A-R negative group. The prognosis of two groups were compared. Kaplan-Meier method and Log-Rank test were used to analyze the survival of the patients.Results:Among 28 cases of IALL, there were 10 males and 18 females, with the onset age of 10.9 (9.4,11.8) months. In terms of immune classification, 25 cases were B-ALL (89%), while the remaining 3 cases were T-ALL (11%). Most infant B-ALL showed pro-B lymphocyte phenotype (16/25,64%). A total of 22 cases (79%) obtained chromosome karyotype results, of which 7 were normal karyotypes, no complex karyotypes and 15 were abnormal karyotypes were found. Among abnormal karyotypes, there were 4 cases of t (9; 11), 2 cases of t (4; 11), 2 cases of t (11; 19), 1 case of t (1; 11) and 6 cases of other abnormal karyotypes. A total of 19 cases (68%) were positive for KMT2A-R detected by FISH. The KMT2A fusion gene was detected by real-time PCR in 16 cases (57%). A total of 24 patients completed standardized induction chemotherapy and were able to undergo efficacy evaluation, 23 cases (96%) achieved complete remission through induction chemotherapy, 4 cases (17%) died of relapse. The 5-year event free survival rate (EFS) was (46±13)%, and the 5-year overall survival rate (OS) was (73±10)%.The survival time was 31.3 (3.3, 62.5) months. There was no significant statistical difference in 5-year EFS ((46±14)% vs. (61±18)%) and 5-year OS ((64±13)% vs. (86±13)%) between the KMT2A-R positive group (15 cases) and the KMT2A-R negative group (9 cases) ( χ2=1.88, 1.47, P=0.170, 0.224). Conclusions:Most IALL patients were accompanied by KMT2A-R. They had poor tolerance to traditional chemotherapy, the relapse rate during treatment was high and the prognosis was poor.

Objective:To explore the utility of combining repeated transcranial magnetic stimulation (rTMS) with action observation therapy (AOT) in improving the upper limb motor functioning of children with hemiplegic spastic cerebral palsy (HSCP).Methods:A total of 66 children with HSCP were randomly divided into a sham stimulation group, an rTMS group and a combination group, each of 22. In addition to routine rehabilitation, the sham stimulation and rTMS groups received the relevant treatment or sham treatment, while the combination group also received action observation therapy (AOT). The treatment was administered daily, five times a week for 12 weeks. Before and after the treatment, everyone′s upper limb muscle tone was evaluated using the modified Ashworth Scale (MAS), and fine motor function, grasping and hand coordination were quantified using the fine component of the Peabody Motor Development Scale (PDMS-FM) and the Carroll upper limb function test (UEFT).Results:After the treatment, significant improvement was documented in the average MAS scores of the bicipital arm and wrist flexors of all three groups, and also in their average PDMS-FM scores, fine motor quotient (FMQ) scores and UEFT scores. After 12 weeks the combination group significantly out-scored the other two groups in terms of their average biceps and wrist flexor MAS scores, PDMS-FM grasping area and visual-motor integration area scores, FMQ score and UEFT score. There was no significant difference between the other two groups in any of the outcome measurements, on average.Conclusions:Supplementing rTMS and routine rehabilitation with AOT more effectively improves the upper limb muscle tension, upper limb functioning and fine finger manipulation of children with hemiplegic spastic cerebral palsy.

【Objective】 To investigate the feasibility and safety of semiconductor blue laser in the treatment of non-muscle invasive bladder cancer (NMIBC) in the day surgery model. 【Methods】 The clinical data of 22 NMIBC patients (average age 55.8 years and tumor size 1.4 cm) who underwent outpatient screening and accepted blue laser ambulatory surgery in our hospital during Jun.2022 and Sep.2022 were retrospectively analyzed. On the day of admission, transurethral resection of cancer was performed using blue laser en bloc enucleation. On the day of surgery or in the morning of next day, bladder irrigation was stopped, the catheter was removed, and patients were discharged. The baseline data, pre-hospital waiting time, operation time, length of hospital stay, hemoglobin decrease, complications and management, follow-up, medical costs, and patients’ satisfaction rate were recorded. 【Results】 The pre-hospital waiting time was 2 to 7 days, average (4.1±1.3)days. The operation time was 29 to 50 minutes, average (40.8±5.5)minutes. The length of hospital stay was 0.6 to 1.2 days, average (0.9±0.2)days. Hemoglobin decrease was 1 g/L to 8 g/L, average (3.8±1.8)g/L. The catheter was indwelt for 0.5 to 1 day, average (0.7±0.1)day. The medical costs were 13 790 to 16 811 Yuan, average (14 941.5±690.2) Yuan. Patients’ satisfaction rate was 100.0%. Mild intraoperative and postoperative complications occurred in 2 cases. One patient developed symptoms of cystitis which disappeared after 2 days of oral antibiotic cefixime, and another patient developed bladder spasm which was relieved after oral solifenacin succinate tablets. No adverse events such as obturator nerve reflex or bladder perforation occurred. After removal of the catheter, no urinary retention was observed. 【Conclusion】 This study was the first to apply blue laser ambulatory surgery in the treatment of bladder cancer, confirming that it is a safe, feasible, economical and efficient model for selected patients, which can be promoted in suitable hospitals.

BACKGROUND: Pathological cardiac hypertrophy is one of the main activators of heart failure. Currently, no drug can completely reverse or inhibit the development of pathological cardiac hypertrophy. To this end, we proposed a silicate ion therapy based on extract derived from calcium silicate (CS) bioceramics for the treatment of angiotensin II (Ang II) induced cardiac hypertrophy. METHODS: In this study, the Ang II induced cardiac hypertrophy mouse model was established, and the silicate ion extract was injected to mice intravenously. The cardiac function was evaluated by using a high-resolution Vevo 3100 small animal ultrasound imaging system. Wheat germ Agglutinin, Fluo4-AM staining and immunofluorescent staining was conducted to assess the cardiac hypertrophy, intracellular calcium and angiogenesis of heart tissue, respectively. RESULTS: The in vitro results showed that silicate ions could inhibit the cell size of cardiomyocytes, reduce cardiac hypertrophic gene expression, including atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and b-myosin heavy chain (b-MHC), decrease the content of intracellular calcium induced by Ang II. In vivo experiments in mice confirmed that intravenous injection of silicate ions could remarkably inhibit the cardiac hypertrophy and promote the formation of capillaries, further alleviating Ang II-induced cardiac function disorder. CONCLUSION This study demonstrated that the released silicate ions from CS possessed potential value as a novel therapeutic strategy of pathological cardiac hypertrophy, which provided a new insight for clinical trials.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective:To systematically integrate the symptom experience of chemotherapy-induced peripheral neuropathy in cancer patients.Methods:Qualitative researches on the symptom experience of chemotherapy-induced peripheral neuropathy in cancer patients were searched through PubMed, Cochrane Library, Joanna Briggs Iistitute (JBI), Embase, Web of Science, OVID, EBSCO, China National Knowledge Infrastruture, Wanfang Database, VIP, SinoMed. The retrieval period was from the establishment of database to November 30, 2021. The quality of included studies was assessed using the evaluation tool of JBI Evidence-Based Health Care Centre Australia. The results were synthesized by the integrating method.Results:A total of 13 studies were included, 45 results were extracted, 13 categories were classified, and 6 integrated results were synthesized: patients and medical staff often ignore chemotherapy-induced peripheral neuritis; the signs of chemotherapy-induced peripheral neuropathy are complex and difficult to be accurately described; patients' complex emotional experience; chemotherapy-induced peripheral neuropathy seriously affects patients' quality of life; patients cope with their illness in a variety of ways; patients long for professional guidance and social support.Conclusions:Medical staff should pay more attention to chemotherapy-induced peripheral neuropathy, pay attention to patients' negative emotions and provide professional guidance, strengthen the social support system and rebuild patients' confidence in treatment.